Antipsychotic prescription, assumption and conversion to psychosis: resolving missing clinical links to optimize prevention through precision

作者：Tianhong Zhang, Andrea Raballo, Jiahui Zeng, RanPiao Gan, GuiSen Wu, YanYan Wei, Lihua Xu, XiaoChen Tang, YeGang Hu, Yingying Tang, HaiChun Liu, Tao Chen, Chunbo Li, Jijun Wang · 发表于：Schizophrenia · 年份：2022 · DOI：10.1038/s41537-022-00254-8 · 被引用次数：18 · 研究领域：Schizophrenia research and treatment、Mental Health and Psychiatry、Mental Health Research Topics

The current concept of clinical high-risk(CHR) of psychosis relies heavily on "below-threshold" (i.e. attenuated or limited and intermittent) psychotic positive phenomena as predictors of the risk for future progression to "above-threshold" positive symptoms (aka "transition" or "conversion"). Positive symptoms, even at attenuated levels are often treated with antipsychotics (AP) to achieve clinical stabilization and mitigate the psychopathological severity. The goal of this study is to contextually examine clinicians' decision to prescribe AP, CHR individuals' decision to take AP and psychosis conversion risk in relation to prodromal symptoms profiles. CHR individuals (n = 600) were recruited and followed up for 2 years between 2016 and 2021. CHR individuals were referred to the participating the naturalistic follow-up study, which research procedure was independent of the routine clinical treatment. Clinical factors from the Structured Interview for Prodromal Syndromes (SIPS) and global assessment of function (GAF) were profiled via exploratory factor analysis (EFA), then the extracted factor structure was used to investigate the relationship of prodromal psychopathology with clinicians' decisions to AP-prescription, CHR individuals' decisions to AP-taking and conversion to psychosis. A total of 427(71.2%) CHR individuals were prescribed AP at baseline, 532(88.7%) completed the 2-year follow-up, 377(377/532, 70.9%) were taken AP at least for 2 weeks during the follow-up. EF...