Abstract:
To be relevant to healthcare systems, the clinical high risk for psychosis (CHR-P) concept should denote a specific (i.e., unique) clinical population and provide useful information to guide the choice of intervention. The current study applied network analyses to examine the clinical specificities of CHR-P youths compared to general help-seekers and non-CHR-P youth. 146 CHR-P (mean age = 14.32 years) and 103 non-CHR-P (mean age = 12.58 years) help-seeking youth were recruited from a neuropsychiatric unit and assessed using the Structured Interview for Psychosis-Risk Syndromes, Children\'s Depression Inventory, Multidimensional Anxiety Scale for Children, Global Functioning: Social, Global Functioning: Role, and Wechsler Intelligence Scale for Children/Wechsler Adult Intelligence Scale. The first network structure comprised the entire help-seeking sample (i.e., help-seekers network), the second only CHR-P patients (i.e., CHR-P network), and the third only non-CHR-P patients (i.e., non-CHR-P network). In the help-seekers network, each variable presented at least one edge. In the CHR-P network, two isolated \"archipelagos of symptoms\" were identified: (a) a subgraph including functioning, anxiety, depressive, negative, disorganization, and general symptoms; and (b) a subgraph including positive symptoms and the intelligence quotient. In the non-CHR-P network, positive symptoms were negatively connected to functioning, disorganization, and negative symptoms. Positive symptoms were less connected in the CHR-P network, indicating a need for specific interventions alongside those treating comorbid disorders. The findings suggest specific clinical characteristics of CHR-P youth to guide the development of tailored interventions, thereby supporting the clinical utility of the CHR-P concept.
摘要:
与医疗保健系统相关,临床精神病高风险(CHR-P)概念应表示特定的(即,独特)的临床人群,并提供有用的信息来指导干预措施的选择。当前的研究应用网络分析来检查CHR-P青年与一般求助者和非CHR-P青年相比的临床特异性。从神经精神科招募了146名CHR-P(平均年龄=14.32岁)和103名非CHR-P(平均年龄=12.58岁)寻求帮助的年轻人,并使用精神病风险综合征的结构化访谈进行了评估,儿童抑郁量表,儿童多维焦虑量表,全球功能:社会,全局功能:角色,韦氏儿童智力量表/韦氏成人智力量表。第一个网络结构包括整个求助样本(即,求助网络),仅次于CHR-P的患者(即,CHR-P网络),和第三位仅有的非CHR-P患者(即,非CHR-P网络)。在求助网络中,每个变量至少呈现一条边。在CHR-P网络中,确定了两个孤立的“症状群岛”:(A)一个子图,包括功能,焦虑,抑郁,负,杂乱无章,和一般症状;和(b)包括阳性症状和智商的子图。在非CHR-P网络中,阳性症状与功能呈负相关,杂乱无章,和阴性症状。阳性症状在CHR-P网络中的联系较少,这表明需要具体的干预措施以及那些治疗合并症的干预措施。研究结果表明,CHR-P青年的特定临床特征可以指导定制干预措施的发展。从而支持CHR-P概念的临床应用。