University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
Eur Child Adolesc Psychiatry. 2023 Oct;32(10):1841-1852. doi: 10.1007/s00787-022-02003-9. Epub 2022 May 18.
Among individuals with clinical high risk for psychosis (CHR), perceptive symptoms are more frequent but have less clinical significance in children/adolescents compared to adults. However, findings are based on clinical interviews relying on patient's recall capacity. Ecological momentary assessment (EMA) can be used to explore experiences in real-time in the subject's daily life. The aim of this study was to assess frequency and stability of (perceptive and non-perceptive) CHR symptoms and to explore potential age effects. EMA was used in a sample of an early detection for psychosis service in Bern, Switzerland (N = 66; 11-36 years). CHR symptoms were recorded in random time intervals for seven days: eight assessments per day per subject, minimum time between prompts set at 25 min. CHR symptoms were additionally assessed with semi-structured interviews including the 'Structured Interview for Psychosis-Risk Syndromes' and the 'Schizophrenia Proneness Instruments'. Mixed-effects linear regression analysis on the frequency of CHR symptoms revealed a significant effect of age group, and the interaction CHR symptoms x age group for both perceptive and non-perceptive symptoms. Further, regarding stability of CHR symptoms, there was a significant effect of the interaction CHR symptoms x age group for perceptive symptoms only. Based on EMA, perceptive CHR symptoms were more frequently reported but less stable in children/adolescents compared with adults. Together with previous findings, our finding of higher instability/variability of perceptive symptoms in younger persons might suggest that with advancing age and more stability of CHR symptoms, clinical relevance (reduced psychosocial functioning) may increase.
在有精神病高危临床症状（CHR）的个体中，与成年人相比，儿童和青少年的知觉症状更为常见，但临床意义较小。然而，这些发现是基于依赖于患者回忆能力的临床访谈得出的。生态瞬时评估（EMA）可用于在受试者的日常生活中实时探索体验。本研究的目的是评估（知觉和非知觉）CHR 症状的频率和稳定性，并探讨潜在的年龄效应。在瑞士伯尔尼的精神病早期发现服务中，使用 EMA 对一个样本进行了评估（N=66；年龄 11-36 岁）。在七天的随机时间间隔内记录 CHR 症状：每个受试者每天进行八次评估，每个提示之间的最小时间间隔设定为 25 分钟。使用包括“精神病风险综合征结构化访谈”和“精神分裂症倾向量表”的半结构化访谈进一步评估 CHR 症状。对 CHR 症状频率的混合效应线性回归分析显示，年龄组有显著影响，知觉和非知觉症状的 CHR 症状 x 年龄组的交互作用也有显著影响。此外，关于 CHR 症状的稳定性，知觉症状的 CHR 症状 x 年龄组的交互作用有显著影响。基于 EMA，与成年人相比，儿童和青少年报告的知觉 CHR 症状更频繁，但更不稳定。结合以前的发现，我们发现年轻个体的知觉症状不稳定性/可变性更高，这可能表明随着年龄的增长和 CHR 症状的稳定性增加，临床相关性（降低的社会心理功能）可能会增加。
