Florida A&M University, Department of Psychology, Tallahassee, FL 32307, USA.
Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Psychotic Disorders, Shanghai 200030, PR China.
Schizophr Res. 2018 Jul;197:509-515. doi: 10.1016/j.schres.2017.11.029. Epub 2017 Dec 26.
In a previous epidemiological study, we reported on the ascertainment and outcomes of "clinical high risk" (CHR) individuals at the Shanghai Mental Health Center (SMHC, "2011 cohort"). The current study compares demographic and clinical characteristics, including conversion rates, of this sample with a subsequently recruited, independent CHR sample and with published data from western samples.
A new sample of 100 CHR subjects ("2013 cohort") was selected based on screening and semi-structured interviews. Both studies used the Structured Interview for Prodromal Syndromes (SIPS) for CHR assessment and conducted a naturalistic two-year follow-up. The two cohorts were compared on conversion rates, demographic and clinical characteristics, psychosis risk symptoms, and risk factors for psychotic conversion.
Ninety one (91%) of the 2013 cohort subjects completed the clinical two-year follow-up and 25 (27.5% of the 91) converted to a psychotic disorder over the follow-up period. A comparison of conversions to full psychosis between the 2013 and the 2011 cohorts showed no significant difference in time to conversion (Pairwise comparison: χ=0.3, p=0.562). Both cohort studies showed that CHR subjects with more severe clinical symptoms at baseline and decline in functioning were more likely to convert to psychosis.
Conversion rates in this new, independent Chinese sample are similar to those reported in non-Chinese samples and to the 2011 cohort. Future research is needed to examine whether the implementation of early intervention for CHR/prodromal symptoms reduces the risk of psychosis and decreases the conversion rate.
在之前的一项流行病学研究中，我们报告了上海精神卫生中心（SMHC，“2011 队列”）中“临床高风险”（CHR）个体的确定和结局。本研究比较了该样本与随后招募的独立 CHR 样本以及来自西方样本的已发表数据的人口统计学和临床特征，包括转化率。
根据筛查和半结构化访谈，选择了新的 100 名 CHR 受试者（“2013 队列”）。两项研究均使用前驱综合征结构化访谈（SIPS）对 CHR 进行评估，并进行了为期两年的自然随访。对两个队列的转化率、人口统计学和临床特征、精神病风险症状以及精神病转化的危险因素进行了比较。
2013 队列的 91 名（91%）受试者完成了临床两年随访，25 名（91 名中的 27.5%）在随访期间转化为精神病。对 2013 队列和 2011 队列的完全精神病转化率进行比较，转化时间无显著差异（两两比较：χ=0.3，p=0.562）。两项队列研究均表明，基线时临床症状更严重和功能下降的 CHR 受试者更有可能转化为精神病。
这个新的、独立的中国样本的转化率与非中国样本和 2011 队列报告的转化率相似。未来需要研究早期干预 CHR/前驱症状是否能降低精神病风险和降低转化率。
