Moe Aubrey M, Cowan Henry R, Manges Margaret, Wastler Heather M, Hamilton Sarah, Kilicoglu Melissa, Holmes Anne C, Breitborde Nicholas J K
Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio, USA.
Department of Psychology, The Ohio State University, Columbus, Ohio, USA.
Early Interv Psychiatry. 2024 Oct;18(10):888-893. doi: 10.1111/eip.13590. Epub 2024 Jul 10.
Despite increasingly refined tools for identifying individuals at clinical high-risk for psychosis (CHR-P), less is known about the effectiveness of CHR-P interventions. The significant clinical heterogeneity among CHR-P individuals suggests that interventions may need to be personalized during this emerging illness phase. We examined longitudinal trajectories within-persons during treatment to investigate whether baseline factors predict symptomatic and functional outcomes.
A total of 36 CHR-P individuals were rated on attenuated positive symptoms and functioning at baseline and each week during CHR-P step-based treatment.
Linear mixed-effects models revealed that attenuated positive symptoms decreased during the study period, while functioning did not significantly change. When examining baseline predictors, a significant group-by-time interaction emerged whereby CHR-P individuals with more psychiatric comorbidities at baseline (indicating greater clinical complexity) improved in functioning during the study period relative to CHR-P individuals with fewer comorbidities.
Individual differences in clinical complexity may predict functional response during the early phases of CHR-P treatment.
尽管用于识别临床高危精神病个体（CHR-P）的工具日益精细，但对于CHR-P干预措施的有效性了解较少。CHR-P个体之间显著的临床异质性表明，在这一疾病初期阶段，干预措施可能需要个性化。我们研究了治疗期间个体的纵向轨迹，以调查基线因素是否能预测症状和功能结局。
共有36名CHR-P个体在基线时以及在基于CHR-P步骤的治疗期间每周接受减弱的阳性症状和功能评定。
线性混合效应模型显示，在研究期间减弱的阳性症状有所减少，而功能没有显著变化。在检查基线预测因素时，出现了显著的组×时间交互作用，即基线时合并更多精神疾病（表明临床复杂性更高）的CHR-P个体相对于合并症较少的CHR-P个体在研究期间功能有所改善。
临床复杂性的个体差异可能预测CHR-P治疗早期阶段的功能反应。
