Time‐course of clinical symptoms in young people at ultra‐high risk for transition to psychosis. Issue 6 (22nd July 2021)

• Record Type: Journal Article
• Authors: Meneghelli, Anna; Cocchi, Angelo; Meliante, Maria; Barbera, Simona; Malvini, Lara; Monzani, Emiliano; Preti, Antonio; Percudani, Mauro
• Is Part Of: Early intervention in psychiatry. Volume 16:Issue 6(2022)
• Page Start: 600
• Page End: 608
• Publication Date: 2021-07-22
• Subjects: early intervention -- growth mixed model -- heterogeneity -- psychosis -- ultra‐high risk; Mental health -- Periodicals; Psychiatry -- Periodicals; Psychiatry -- Research -- Periodicals; Mental illness -- Prevention -- Research -- Periodicals; Mental illness -- Treatment -- Research -- Periodicals; 616.89
• DOI: 10.1111/eip.13201
• Languages: English
• ISSNs: 1751-7885

Abstract

Abstract: Background: Ultra‐high risk (UHR) people are a heterogeneous group with variable outcomes. This study aimed at (a) estimating trajectories of response to treatment to identify homogeneous subgroups; (b) establishing the impact on these trajectories of known predictors of outcome in UHR subjects. Methods: Mixed models of growth curves and latent class growth analysis (LCGA) were applied to the 24‐item brief psychiatric rating scale (BPRS) to measure the response to treatment over 2 years in 125 UHR participants. Group differences were tested on sociodemographic variables and clinical indicators that are known to affect the outcome in UHR people. Results: BPRS scores decreased across all tested models, with a greater decrease for affective and positive symptoms than for all other dimensions of BPRS. Past admissions to the hospital for psychiatric reasons other than psychosis and the presence of a decline in premorbid functioning before the episode were associated with a slower decrease of BPRS score. LCGA identified three classes, one (82% of participants) with a progressive decrease in the BPRS scores, a second class with a moderate improvement (10%), and a third with no improvement (8%). Those in the 'no improvement' class had a higher chance of receiving a diagnosis of psychosis within the spectrum of schizophrenia. Conclusion: Most UHR individuals that are treated within a specialized service undergo substantial improvement in their psychopathology, but some seem resistant to the protocol of treatment and need close reevaluation within the first 12 months of treatment.