Joaquim Radua1, Cathy Davies2, Paolo Fusar-Poli3. 1. Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain; Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden. 2. Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK. 3. Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK; Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy; National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK. Electronic address: paolo.fusar-poli@kcl.ac.uk.
Abstract
BACKGROUND: Individuals at Clinical High Risk for Psychosis (CHR-P) may differ considerably in their response to indicated preventive interventions. No studies have tested this. METHOD: PRISMA-compliant systematic review of the Web of Science (MEDLINE), PsycInfo, CENTRAL and unpublished/gray literature up to 1 September 2019. RCTs in CHR-P individuals, reporting on attenuated positive psychotic symptoms were included. The primary outcome was the variability ratio between the variance of the severity of attenuated positive psychotic symptoms in the indicated intervention condition vs the control condition (needs-based interventions, NBI) at 6 and 12 months. Random effect models, C statistics, meta-regressions/sensitivity analyses and Cochrane Risk of Bias assessment were performed. RESULTS: Overall, 1707 individuals from 14 RCTs (57% male, mean age = 20) reporting on the impact of preventive interventions on attenuated positive psychotic symptoms were included. At 6 months, the variability ratio was 1 (95% CI 0.89-1.12). At 12 months, the variability ratio was higher in the indicated intervention compared to the NBI condition but not statistically different: 1.09 (95% CI 0.94-1.25). Between-study heterogeneity was serious (I2 = 51% and 68%, respectively), but sensitivity analysis suggested it may be related to two outlying studies or larger variability in the response to treatment in small studies. CONCLUSIONS: There is no evidence for individual differences in CHR-P response to preventive treatments. Although the study cannot exclude that subsets of CHR-P individuals may respond differently to preventive treatments, it indicates that the average effect of preventive interventions is a reasonable estimate for the CHR-P individual.
BACKGROUND: Individuals at Clinical High Risk for Psychosis (CHR-P) may differ considerably in their response to indicated preventive interventions. No studies have tested this. METHOD: PRISMA-compliant systematic review of the Web of Science (MEDLINE), PsycInfo, CENTRAL and unpublished/gray literature up to 1 September 2019. RCTs in CHR-P individuals, reporting on attenuated positive psychotic symptoms were included. The primary outcome was the variability ratio between the variance of the severity of attenuated positive psychotic symptoms in the indicated intervention condition vs the control condition (needs-based interventions, NBI) at 6 and 12 months. Random effect models, C statistics, meta-regressions/sensitivity analyses and Cochrane Risk of Bias assessment were performed. RESULTS: Overall, 1707 individuals from 14 RCTs (57% male, mean age = 20) reporting on the impact of preventive interventions on attenuated positive psychotic symptoms were included. At 6 months, the variability ratio was 1 (95% CI 0.89-1.12). At 12 months, the variability ratio was higher in the indicated intervention compared to the NBI condition but not statistically different: 1.09 (95% CI 0.94-1.25). Between-study heterogeneity was serious (I2 = 51% and 68%, respectively), but sensitivity analysis suggested it may be related to two outlying studies or larger variability in the response to treatment in small studies. CONCLUSIONS: There is no evidence for individual differences in CHR-P response to preventive treatments. Although the study cannot exclude that subsets of CHR-P individuals may respond differently to preventive treatments, it indicates that the average effect of preventive interventions is a reasonable estimate for the CHR-P individual.
Authors: Ana Catalan; Joaquim Radua; Robert McCutcheon; Claudia Aymerich; Borja Pedruzo; Miguel Ángel González-Torres; Helen Baldwin; William S Stone; Anthony J Giuliano; Philip McGuire; Paolo Fusar-Poli Journal: Transl Psychiatry Date: 2022-05-12 Impact factor: 7.989
Authors: Helen Baldwin; Joaquim Radua; Mathilde Antoniades; Shalaila S Haas; Sophia Frangou; Ingrid Agartz; Paul Allen; Ole A Andreassen; Kimberley Atkinson; Peter Bachman; Inmaculada Baeza; Cali F Bartholomeusz; Michael W L Chee; Tiziano Colibazzi; Rebecca E Cooper; Cheryl M Corcoran; Vanessa L Cropley; Bjørn H Ebdrup; Adriana Fortea; Louise Birkedal Glenthøj; Holly K Hamilton; Kristen M Haut; Rebecca A Hayes; Ying He; Karsten Heekeren; Michael Kaess; Kiyoto Kasai; Naoyuki Katagiri; Minah Kim; Jochen Kindler; Mallory J Klaunig; Shinsuke Koike; Alex Koppel; Tina D Kristensen; Yoo Bin Kwak; Jun Soo Kwon; Stephen M Lawrie; Irina Lebedeva; Jimmy Lee; Ashleigh Lin; Rachel L Loewy; Daniel H Mathalon; Chantal Michel; Romina Mizrahi; Paul Møller; Barnaby Nelson; Takahiro Nemoto; Dorte Nordholm; Maria A Omelchenko; Christos Pantelis; Jayachandra M Raghava; Jan I Røssberg; Wulf Rössler; Dean F Salisbury; Daiki Sasabayashi; Ulrich Schall; Lukasz Smigielski; Gisela Sugranyes; Michio Suzuki; Tsutomu Takahashi; Christian K Tamnes; Jinsong Tang; Anastasia Theodoridou; Sophia I Thomopoulos; Alexander S Tomyshev; Peter J Uhlhaas; Tor G Værnes; Therese A M J van Amelsvoort; Theo G M Van Erp; James A Waltz; Lars T Westlye; Stephen J Wood; Juan H Zhou; Philip McGuire; Paul M Thompson; Maria Jalbrzikowski; Dennis Hernaus; Paolo Fusar-Poli Journal: Transl Psychiatry Date: 2022-07-26 Impact factor: 7.989