Haining Kate, Gajwani Ruchika, Gross Joachim, Gumley Andrew I, Lawrie Stephen M, Schultze-Lutter Frauke, Schwannauer Matthias, Uhlhaas Peter J
School of Psychology and Neuroscience, University of Glasgow, Glasgow, UK.
School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Schizophr Bull Open. 2024 Nov 12;5(1):sgae029. doi: 10.1093/schizbullopen/sgae029. eCollection 2024 Jan.
Clinical high-risk for psychosis (CHR-P) individuals are typically recruited from clinical services but the clinical and functional outcomes of community-recruited CHR-P individuals remain largely unclear. The Youth Mental Health Risk and Resilience Study (YouR-Study) obtained a community sample of CHR-P individuals through an online-screening approach and followed-up these individuals for a period of up to 3 years to determine transition rates, persistence of attenuated psychotic symptoms (APS) and functional outcomes. Baseline data were obtained from = 144 CHR-P participants, = 51 participants who met online cutoff criteria but not CHR-P criteria (CHR-Ns), and = 58 healthy controls. Baseline assessments included clinical measures for assessing CHR-P status, including the Comprehensive Assessment of At-Risk Mental States (CAARMS) and the Schizophrenia Proneness Instrument, Adult version (SPI-A), as well as functioning and cognitive measures. CHR-P and CHR-N groups were followed-up. Results show that 12.1% of CHR-P individuals transitioned to psychosis over 3 years, with no transitions in the CHR-N group. Nearly 60% of CHR-P individuals experienced poor functional outcome (PFO) and over 40% experienced persistent APS. A combination of CAARMS/SPI-A criteria was associated with a higher likelihood of PFO, but not with transition to psychosis nor APS persistence. However, transition risk was generally higher among those meeting both CAARMS/SPI-A criteria (64.3%) vs CAARMS (28.6%) or SPI-A (7.1%) alone. In summary, community-recruited CHR-P individuals are characterized by similar clinical characteristics and longitudinal outcomes to those recruited from clinical services, emphasizing the need to widen the scope of early detection and intervention strategies.
临床精神病高危（CHR-P）个体通常从临床服务机构招募，但社区招募的CHR-P个体的临床和功能结局在很大程度上仍不明确。青少年心理健康风险与复原力研究（YouR-Study）通过在线筛查方法获得了CHR-P个体的社区样本，并对这些个体进行了长达3年的随访，以确定转化率、精神病性症状衰减（APS）的持续性和功能结局。基线数据来自144名CHR-P参与者、51名符合在线临界标准但不符合CHR-P标准的参与者（CHR-Ns）以及58名健康对照者。基线评估包括用于评估CHR-P状态的临床测量，包括高危精神状态综合评估（CAARMS）和成人版精神分裂症易感性量表（SPI-A），以及功能和认知测量。对CHR-P组和CHR-N组进行了随访。结果显示，12.1%的CHR-P个体在3年内转变为精神病，CHR-N组无转变。近60%的CHR-P个体经历了不良功能结局（PFO），超过40%的个体经历了持续性APS。CAARMS/SPI-A标准的组合与PFO可能性较高相关，但与转变为精神病或APS持续性无关。然而，同时符合CAARMS/SPI-A标准的个体（64.3%）的转变风险通常高于仅符合CAARMS（28.6%）或SPI-A（7.1%）标准的个体。总之，社区招募的CHR-P个体具有与临床服务机构招募的个体相似的临床特征和纵向结局，强调有必要扩大早期检测和干预策略的范围。
