Addington Jean, Farris Megan, Devoe Daniel, Metzak Paul
Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, AB, Canada.
NPJ Schizophr. 2020 Oct 5;6(1):27. doi: 10.1038/s41537-020-00117-0.
Over the past 20 years there has been a great deal of research into those considered to be at risk for developing psychosis. Much has been learned and studies have been encouraging. The aim of this paper is to offer an update of the current status of research on risk for psychosis, and what the next steps might be in examining the progression from CHR to psychosis. Advances have been made in accurate prediction, yet there are some methodological issues in ascertainment, diagnosis, the use of data-driven selection methods and lack of external validation. Although there have been several high-quality treatment trials the heterogeneity of this clinical high-risk population has to be addressed so that their treatment needs can be properly met. Recommendations for the future include more collaborative research programmes, and ensuring they are accessible and harmonized with respect to criteria and outcomes so that the field can continue to move forward with the development of large collaborative consortiums as well as increased funding for multisite projects.
在过去20年里，针对那些被认为有患精神病风险的人群进行了大量研究。我们已经了解到很多情况，研究结果也鼓舞人心。本文旨在介绍精神病风险研究的现状更新，以及从临床高危状态（CHR）发展到精神病的下一步研究方向。在准确预测方面已取得进展，但在确定、诊断、使用数据驱动的选择方法以及缺乏外部验证等方面存在一些方法学问题。尽管已经进行了多项高质量的治疗试验，但必须解决这一临床高危人群的异质性问题，以便能够恰当地满足他们的治疗需求。对未来的建议包括开展更多合作研究项目，并确保这些项目在标准和结果方面具有可及性和协调性，从而使该领域能够随着大型合作联盟的发展以及对多中心项目资金投入的增加而继续前进。
