University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland; University of Basel, Division of Clinical Psychology and Epidemiology, Department of Psychology, Basel, Switzerland.
University of Basel Psychiatric Hospital, Center for Gender Research and Early Detection, Basel, Switzerland.
Schizophr Res. 2019 Aug;210:39-47. doi: 10.1016/j.schres.2018.12.047. Epub 2019 Jan 14.
Research on patients at clinical high risk (CHR) for psychosis has so far mainly focused on those with transition to frank psychosis (CHR-T patients). However, the majority of CHR patients do not transition (CHR-NT patients) and relatively little information is available on their clinical and functional outcome.
We conducted a systematic review on clinical and functional long-term outcome of CHR-NT patients. Studies were included if they had an average follow-up period of at least 24 months and reported on long-term outcome of CHR-NT patients in one or more of the following domains: (non-)remission from CHR, prevalence of clinical symptoms and/or clinical diagnoses (axis I and II), and psychosocial functioning.
Ten publications from seven different single or multicenter studies with average follow-up durations of 2-7.5 years could be included. At the last follow-up assessment 28-71% of CHR-NT patients were not remitted from their CHR and 22-82% still had at least one clinical diagnosis. Approximately half of CHR-NT patients presented with poor psychosocial outcome at 2-year and 6-year follow-up.
The results suggest that, in the long-term, the majority of CHR-NT patients are not in full clinical remission and seem to suffer from one or more clinical disorders and psychosocial impairments. Since relatively few studies could be identified, further research is required to better understand the trajectories and clinical needs of CHR-NT patients.
迄今为止，针对处于精神病临床高风险（CHR）的患者的研究主要集中在那些向明显精神病（CHR-T 患者）转变的患者上。然而，大多数 CHR 患者并未转变（CHR-NT 患者），并且关于他们的临床和功能结局的信息相对较少。
我们对 CHR-NT 患者的临床和功能长期结局进行了系统回顾。如果研究具有至少 24 个月的平均随访期，并在以下一个或多个领域报告了 CHR-NT 患者的长期结局：（CHR 的）缓解情况、临床症状和/或临床诊断（I 轴和 II 轴）的患病率，以及社会心理功能，则将其纳入研究。
从七个不同的单中心或多中心研究中纳入了十篇出版物，这些研究的平均随访时间为 2-7.5 年。在最后一次随访评估时，28-71%的 CHR-NT 患者未从 CHR 中缓解，22-82%的患者仍有至少一种临床诊断。大约一半的 CHR-NT 患者在 2 年和 6 年随访时表现出较差的社会心理结局。
这些结果表明，在长期内，大多数 CHR-NT 患者并未完全缓解，并且似乎患有一种或多种临床疾病和社会心理障碍。由于只能确定少数几项研究，因此需要进一步研究以更好地了解 CHR-NT 患者的轨迹和临床需求。
