Non-psychotic Outcomes in Young People at Ultra-High Risk of Developing a Psychotic Disorder: A Long-Term Follow-up Study.

IF 5.3 1区 医学 Q1 PSYCHIATRY Schizophrenia Bulletin Pub Date : 2024-11-08 DOI:10.1093/schbul/sbae005
Anneliese E Spiteri-Staines, Alison R Yung, Ashleigh Lin, Jessica A Hartmann, Paul Amminger, Patrick D McGorry, Andrew Thompson, Stephen J Wood, Barnaby Nelson
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Abstract

Background: The majority of individuals at ultra-high risk (UHR) for psychosis do not transition to a full threshold psychotic disorder. It is therefore important to understand their longer-term clinical and functional outcomes, particularly given the high prevalence of comorbid mental disorders in this population at baseline.

Aims: This study investigated the prevalence of non-psychotic disorders in the UHR population at entry and long-term follow-up and their association with functional outcomes. Persistence of UHR status was also investigated.

Study design: The sample comprised 102 UHR young people from the Personal Assessment and Crisis Evaluation (PACE) Clinic who had not transitioned to psychosis by long-term follow-up (mean = 8.8 years, range = 6.8-12.1 years since baseline).

Results: Eighty-eight percent of participants at baseline were diagnosed with at least one mental disorder, the majority of which were mood disorders (78%), anxiety disorders (35%), and substance use disorders (SUDs) (18%). This pattern of disorder prevalence continued at follow-up, though prevalence was reduced, with 52% not meeting criteria for current non-psychotic mental disorder. However, 35% of participants developed a new non-psychotic mental disorder by follow-up. Presence of a continuous non-psychotic mental disorder was associated with poorer functional outcomes at follow-up. 28% of participants still met UHR criteria at follow-up.

Conclusions: The study adds to the evidence base that a substantial proportion of UHR individuals who do not transition to psychosis experience persistent attenuated psychotic symptoms and persistent and incident non-psychotic disorders over the long term. Long-term treatment and re-entry into services is indicated.

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罹患精神病的超高风险青少年的非精神病性结果:长期跟踪研究
背景:大多数处于精神病超高风险(UHR)的人不会转变为完全阈值精神病性障碍。因此,了解他们的长期临床和功能结果非常重要,尤其是考虑到这一人群在基线时合并精神障碍的高患病率。研究目的:本研究调查了超高危人群在入院和长期随访时非精神病性障碍的患病率及其与功能结果的关系。研究设计:研究样本包括102名来自个人评估与危机评估(PACE)诊所、在长期随访(平均=8.8年,自基线起=6.8-12.1年)中未转为精神病的UHR年轻人:88%的基线参与者被诊断患有至少一种精神障碍,其中大部分为情绪障碍(78%)、焦虑障碍(35%)和药物使用障碍(18%)。这种精神障碍的流行模式在随访中得以延续,不过流行率有所下降,52%的人不符合当前非精神病性精神障碍的标准。然而,有 35% 的参与者在随访期间出现了新的非精神病性精神障碍。持续存在非精神病性精神障碍与随访时较差的功能结果有关。28%的参与者在随访时仍符合 UHR 标准:这项研究为我们提供了更多的证据,证明有相当一部分未转变为精神病的 UHR 患者会长期出现持续性减弱的精神病性症状以及持续性和偶发性非精神病性障碍。因此需要进行长期治疗并重新接受服务。
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来源期刊
Schizophrenia Bulletin
Schizophrenia Bulletin 医学-精神病学
CiteScore
11.40
自引率
6.10%
发文量
163
审稿时长
4-8 weeks
期刊介绍: Schizophrenia Bulletin seeks to review recent developments and empirically based hypotheses regarding the etiology and treatment of schizophrenia. We view the field as broad and deep, and will publish new knowledge ranging from the molecular basis to social and cultural factors. We will give new emphasis to translational reports which simultaneously highlight basic neurobiological mechanisms and clinical manifestations. Some of the Bulletin content is invited as special features or manuscripts organized as a theme by special guest editors. Most pages of the Bulletin are devoted to unsolicited manuscripts of high quality that report original data or where we can provide a special venue for a major study or workshop report. Supplement issues are sometimes provided for manuscripts reporting from a recent conference.
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