Heterogeneity of Psychosis Risk Within Individuals at Clinical High Risk

作者：Paolo Fusar‐Poli, Marco Cappucciati, Stefan Borgwardt, Scott W. Woods, Jean Addington, Barnaby Nelson, Dorien H. Nieman, Daniel Ståhl, Grazia Rutigliano, Anita Riecher‐Rössler, Andor E. Simon, Masafumi Mizuno, Tae Young Lee, Jun Soo Kwon, May M.L. Lam, Jesús Pérez, Szabolcs Kéri, G. Paul Amminger, Sibylle Metzler, Wolfram Kawohl, Wulf Rössler, Jimmy Lee, Javier Labad, Tim Ziermans, Suk Kyoon An, Chen‐Chung Liu, Kristen A. Woodberry, A. Braham, Cheryl M. Corcoran, Patrick D. McGorry, Alison R. Yung, Philip McGuire · 发表于：JAMA Psychiatry · 年份：2015 · DOI：10.1001/jamapsychiatry.2015.2324 · 被引用次数：448 · 研究领域：Schizophrenia research and treatment、Mental Health and Psychiatry、Tryptophan and brain disorders

IMPORTANCE: Individuals can be classified as being at clinical high risk (CHR) for psychosis if they meet at least one of the ultra-high-risk (UHR) inclusion criteria (brief limited intermittent psychotic symptoms [BLIPS] and/or attenuated psychotic symptoms [APS] and/or genetic risk and deterioration syndrome [GRD]) and/or basic symptoms [BS]. The meta-analytical risk of psychosis of these different subgroups is still unknown. OBJECTIVE: To compare the risk of psychosis in CHR individuals who met at least one of the major inclusion criteria and in individuals not at CHR for psychosis (CHR-). DATA SOURCES: Electronic databases (Web of Science, MEDLINE, Scopus) were searched until June 18, 2015, along with investigation of citations of previous publications and a manual search of the reference lists of retrieved articles. STUDY SELECTION: We included original follow-up studies of CHR individuals who reported the risk of psychosis classified according to the presence of any BLIPS, APS and GRD, APS alone, GRD alone, BS, and CHR-. DATA EXTRACTION AND SYNTHESIS: Independent extraction by multiple observers and random-effects meta-analysis of proportions. Moderators were tested with meta-regression analyses (Bonferroni corrected). Heterogeneity was assessed with the I2 index. Sensitivity analyses tested robustness of results. Publication biases were assessed with funnel plots and the Egger test. MAIN OUTCOMES AND MEASURES: The proportion of each subgroup with any psychotic disorder...