Duration of Untreated Prodromal Psychosis and Cognitive Impairments

作者：Tianhong Zhang, HuiRu Cui, YanYan Wei, XiaoChen Tang, Lihua Xu, YeGang Hu, Yingying Tang, HaiChun Liu, Zixuan Wang, Tao Chen, Chunbo Li, Jijun Wang · 发表于：JAMA Network Open · 年份：2024 · DOI：10.1001/jamanetworkopen.2023.53426 · 被引用次数：15 · 研究领域：Schizophrenia research and treatment、Mental Health and Psychiatry、Bipolar Disorder and Treatment

Importance: The possible association between the duration of untreated prodromal symptoms (DUPrS) and cognitive functioning in individuals at clinical high risk (CHR) for psychosis remains underexplored. Objective: To investigate the intricate interplay between DUPrS, cognitive performance, and conversion outcomes, shedding light on the potential role of DUPrS in shaping cognitive trajectories and psychosis risk in individuals at CHR for psychosis. Design, Setting, and Participants: This cohort study of individuals at CHR for psychosis was conducted at the Shanghai Mental Health Center in China from January 10, 2016, to December 29, 2021. Participants at CHR for psychosis typically exhibit attenuated positive symptoms; they were identified according to the Structured Interview for Prodromal Syndromes, underwent baseline neuropsychological assessments, and were evaluated at a 3-year clinical follow-up. Data were analyzed from August 25, 2021, to May 10, 2023. Exposure: Duration of untreated prodromal symptoms and cognitive impairments in individuals at CHR for psychosis. Main Outcomes and Measures: The primary study outcome was conversion to psychosis. The DUPrS was categorized into 3 groups based on percentiles (33rd percentile for short [≤3 months], 34th-66th percentile for median [4-9 months], and 67th-100th percentile for long [≥10 months]). The DUPrS, cognitive variables, and the risk of conversion to psychosis were explored through quantile regression and Cox proportiona...