Open Access
Meta-analysis of Transition Outcomes in Individuals at High Clinical Risk
Paolo Fusar-Poli,Ilaria Bonoldi,Alison R. Yung,Stefan Borgwardt,Matthew J. Kempton,Lucia Valmaggia,Francesco Barale,Edgardo Caverzasi,Philip McGuire +8 more
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TLDR
In this article, the authors examined the literature to date reporting the transition risk to psychosis in subjects at clinical high risk and found that there was a consistent transition risk, independent of the psychometric instruments used, of 18% after 6 months of follow-up, 22% after 1 year, 29% after 2 years and 36% after 3 years.Abstract:
Context: A substantial proportion of people at clinical high risk of psychosis will develop a psychotic disorder over time. However, the risk of transition to psychosis varies between centers, and some recent work suggests that the risk of transition may be declining. Objective: To quantitatively examine the literature to date reporting the transition risk to psychosis in subjects at clinical high risk. Data Sources: The electronic databases were searched until January 2011. All studies reporting transition risks in patients at clinical high risk were retrieved. Study Selection: Twenty-seven studies met the inclusion criteria, comprising a total of 2502 patients. Data Extraction: Transition risks, as well as demographic, clinical, and methodologic variables, were extracted from each publication or obtained directly from its authors. Data Synthesis: There was a consistent transition risk, independent of the psychometric instruments used, of 18% after 6 months of follow-up, 22% after 1 year, 29% after 2 years, and 36% after 3 years. Significant moderators accounting for heterogeneity across studies and influencing the transition risks were the age of participants, publication year, treatments received, and diagnostic criteria used. There was no publication bias, and a sensitivity analysis confirmed the robustness of the core findings. Conclusions: The state of clinical high risk is associated with a very high risk of developing psychosis within the first 3 years of clinical presentation, and the risk progressively increases across this period. The transition risk varies with the age of the patient, the nature of the treatment provided, and the way the syndrome and transition to psychosis are defined.read more
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Cognitive Functioning in Prodromal Psychosis: A Meta-analysis
Paolo Fusar-Poli,Giacomo Deste,Renata Smieskova,Stefano Barlati,Alison R. Yung,Oliver D. Howes,Rolf-Dieter Stieglitz,Antonio Vita,Philip McGuire,Stefan Borgwardt +9 more
TL;DR: The HR state for psychosis is associated with significant and widespread impairments in neurocognitive functioning and social cognition, and subsequent transition to psychosis is particularly associated with deficits in verbal fluency and memory functioning.
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Predicting Psychosis: Meta-analysis of Transition Outcomes in Individuals at High Clinical Risk
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Comorbid Depressive and Anxiety Disorders in 509 Individuals With an At-Risk Mental State: Impact on Psychopathology and Transition to Psychosis
TL;DR: The ARMS patients are characterized by high prevalence of anxiety and depressive disorders in addition to their attenuated psychotic symptoms, which may reflect core emotional dysregulation processes and delusional mood in prodromal psychosis.
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Evidence-based guidelines for the pharmacological treatment of schizophrenia: recommendations from the British Association for Psychopharmacology:
TL;DR: These guidelines from the British Association for Psychopharmacology address the scope and targets of pharmacological treatment for schizophrenia, and cover the pharmacological management and treatment of schizophrenia across the various stages of the illness.
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Altering the course of schizophrenia: progress and perspectives
Millan Mark,Annie Andrieux,George Bartzokis,Kristin S. Cadenhead,Paola Dazzan,Paolo Fusar-Poli,Jürgen Gallinat,Jay N. Giedd,Dennis R. Grayson,Markus Heinrichs,René S. Kahn,Marie-Odile Krebs,Marion Leboyer,David A. Lewis,Oscar Marín,Philippe Marin,Andreas Meyer-Lindenberg,Patrick D. McGorry,Philip McGuire,Michael John Owen,Paul Patterson,Akira Sawa,Michael Spedding,Peter J. Uhlhaas,Flora M. Vaccarino,Claes Wahlestedt,Daniel R. Weinberger +26 more
TL;DR: A broad-based consideration of the challenges and opportunities inherent in efforts to alter the course of schizophrenia is provided, including 'hybrid' strategies that both relieve presenting symptoms and reduce the risk of transition to schizophrenia or another psychiatric disorder.
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