Zhang TianHong, Wei YanYan, Tang XiaoChen, Xu LiHua, Hu YeGang, Liu HaiChun, Wang ZiXuan, Chen Tao, Li ChunBo, Wang JiJun
Department of Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai 200030, PR China.
Department of Automation, Shanghai Jiao Tong University, Shanghai 200240, PR China.
Schizophr Bull. 2024 Jul 25. doi: 10.1093/schbul/sbae129.
The time taken for an individual who is at the clinical high-risk (CHR) stage to transition to full-blown psychosis may vary from months to years. This temporal aspect, known as the timeframe for conversion to psychosis (TCP), is a crucial but relatively underexplored dimension of psychosis development.
The sample consisted of 145 individuals with CHR who completed a 5-year follow-up with a confirmed transition to psychosis within this period. Clinical variables along with functional variables such as the Global Assessment of Function (GAF) score at baseline (GAF baseline) and GAF-drop from the highest score in the past year. The TCP was defined as the duration from CHR identification to psychosis conversion. Participants were categorized into 3 groups based on TCP: "short" (≤6 months, ≤33.3%), "median" (7-17 months, 33.3%-66.6%), and "long" (≥18 months, ≥66.6%). The quantile regression analysis was applied.
The overall sample had a median TCP of 11 months. Significant differences among the three TCP groups were observed, particularly in GAF-drop (χ2 = 8.806, P = .012), disorganized symptoms (χ2 = 7.071, P = .029), and general symptoms (χ2 = 6.586, P = .037). Greater disorganized symptoms (odds ratio [OR] = 0.824, P = .009) and GAF-drop (OR = 0.867, P = .011) were significantly associated with a shorter TCP, whereas greater general symptoms (OR = 1.198, P = .012) predicted a longer TCP. Quantile regression analysis demonstrated a positive association between TCP and GAF baseline above the 0.7 quantile and a negative association between TCP rank and GAF drop below the 0.5 quantile.
This study underscores the pivotal role of functional characteristics in shaping TCP among individuals with CHR, emphasizing the necessity for a comprehensive consideration of temporal aspects in early prevention efforts.
处于临床高危（CHR）阶段的个体发展为全面性精神病所需的时间可能从数月到数年不等。这一被称为精神病转化时间框架（TCP）的时间维度，是精神病发展过程中一个关键但相对未被充分探索的方面。
样本包括145名CHR个体，他们完成了为期5年的随访，在此期间确诊已转化为精神病。收集了临床变量以及功能变量，如基线时的总体功能评估（GAF）评分（GAF基线）和过去一年中从最高评分下降的GAF值。TCP被定义为从识别CHR到转化为精神病的持续时间。参与者根据TCP被分为三组：“短”（≤6个月，≤33.3%）、“中”（7 - 17个月，33.3% - 66.6%）和“长”（≥18个月，≥66.6%）。应用了分位数回归分析。
总体样本的TCP中位数为11个月。在三个TCP组之间观察到显著差异，特别是在GAF下降方面（χ2 = 8.806，P = 0.012）、紊乱症状方面（χ2 = 7.071，P = 0.029）和一般症状方面（χ2 = 6.586，P = 0.037）。更严重的紊乱症状（优势比[OR] = 0.824，P = 0.009）和GAF下降（OR = 0.867，P = 0.011）与较短的TCP显著相关，而更严重的一般症状（OR = 1.198，P = 0.012）预示着较长的TCP。分位数回归分析表明，在0.7分位数以上，TCP与GAF基线呈正相关，在0.5分位数以下，TCP排名与GAF下降呈负相关。
本研究强调了功能特征在塑造CHR个体的TCP方面的关键作用，强调了在早期预防工作中全面考虑时间维度的必要性。
