Gauld Christophe, Fourneret Pierre, Alderson-Day Ben, Palmer-Cooper Emma, Dondé Clément
Department of Child and Adolescent Psychopathology, CHU de Lyon, 69000, Lyon, France.
Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon 1, 69000, Lyon, France.
Eur Arch Psychiatry Clin Neurosci. 2025 Apr;275(3):947-958. doi: 10.1007/s00406-024-01876-y. Epub 2024 Aug 21.
One of the main goals for supporting people with a psychotic disorder is early detection and intervention, and the detection of Clinical High Risk (CHR) is a major challenge in this respect. This study sought to compare core symptoms of CHR for psychosis networks based on two CHR self-assessment tools, across different risk thresholds and age groups. This cross-sectional online investigation analyzed 936 individuals for CHR, in France and the UK, with the Prodromal Questionnaire-16 (PQ-16) and the Perceptual and Cognitive Aberrations (PCA). Twelve different symptom networks were constructed, assessing relationships, compactness, centrality, predictability, and comparisons between them, based on different thresholds and age groups. In the above-threshold PQ-16 network, the most central symptom was "Voices or whispers"; in the PCA network, the most central symptom was "Non-relevant thoughts distract or bother". They presented low overall predictability. No significant difference was found between them. This study makes three key contributions. First, this cross-network analyses highlight the relative importance of some central symptoms. Secondly, comparisons between networks demonstrate the unity of the CHR construct across scales, thresholds, and ages, affirming its phenotypic homogeneity, an essential issue for patient care pathways. Thirdly, the low average network predictability suggests the existence of unconsidered symptoms within these CHR networks. These results shed light on the organization of CHR symptoms using routine clinical questionnaires, offering insights for preventive targets in a logic of precision semiology.
支持患有精神障碍的人的主要目标之一是早期发现和干预，而临床高危（CHR）的检测是这方面的一项重大挑战。本研究旨在基于两种CHR自我评估工具，比较不同风险阈值和年龄组的精神病网络中CHR的核心症状。这项横断面在线调查在法国和英国，使用前驱症状问卷-16（PQ-16）和感知与认知异常（PCA）对936名个体进行了CHR分析。构建了12个不同的症状网络，基于不同的阈值和年龄组评估它们之间的关系、紧凑性、中心性、可预测性以及相互比较。在前驱症状问卷-16阈值以上的网络中，最核心的症状是“声音或低语”；在PCA网络中，最核心的症状是“无关的想法分散注意力或困扰”。它们的整体可预测性较低。两者之间未发现显著差异。本研究有三项关键贡献。第一，这种跨网络分析突出了一些核心症状的相对重要性。第二，网络之间进行的比较表明CHR结构在量表、阈值和年龄方面具有统一性，肯定了其表型同质性，这是患者护理途径中的一个关键问题。第三，较低的平均网络可预测性表明这些CHR网络中存在未被考虑的症状。这些结果通过常规临床问卷揭示了CHR症状的组织情况，为精准符号学逻辑中的预防靶点提供了见解。
