Improving Prognostic Accuracy in Subjects at Clinical High Risk for Psychosis: Systematic Review of Predictive Models and Meta-analytical Sequential Testing Simulation

AbstractPsychotic experiences can occur in autism spectrum disorders (ASD). Some of the ASD individuals with these experiences may fulfil Clinical High-Risk for Psychosis (CHR-P) criteria. A systematic literature search was performed to review the information on ASD and CHR-P. A meta-analysis of the proportion of CHR-P in ASD was conducted. The systematic review included 13 studies. The mean age of ASD individuals across the included studies was 11.09 years. The Attenuated Psychosis Syndrome subgroup was the most frequently reported. Four studies were meta-analysed, showing that 11.6% of CHR-P individuals have an ASD diagnosis. Symptoms of prodromal psychosis may be present in individuals with ASD. The transition from CHR-P to psychosis is not affected by ASD.

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Brain changes associated with negative symptoms in clinical high risk for psychosis: A systematic review

Neuroscience & Biobehavioral Reviews ◽

10.1016/j.neubiorev.2020.07.041 ◽

2020 ◽

Vol 118 ◽

pp. 367-383

Author(s):

Paul D. Metzak ◽

Daniel J. Devoe ◽

Amanda Iwaschuk ◽

Amy Braun ◽

Jean Addington

Keyword(s):

Systematic Review ◽

High Risk ◽

Negative Symptoms ◽

Clinical High Risk ◽

Brain Changes

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S154. TOBACCO SMOKING AND CLINICAL HIGH RISK: A SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EVIDENCE

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa031.220 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S94-S95

Author(s):

Andrea De Micheli ◽

Albertine van Lawick van Pabst ◽

Enass Yossef ◽

Philip McGuire ◽

Paolo Fusar-Poli

Keyword(s):

Systematic Review ◽

High Risk ◽

Physical Health ◽

Tobacco Use ◽

Citation Index ◽

Meta Analysis ◽

Assessment Tools ◽

Clinical High Risk ◽

Increased Risk ◽

Russian Science Citation Index

Abstract Background There is converging evidence that youths at clinical high risk (CHR) are not only likely to develop the first episode of psychosis but also to develop poor physical outcomes. Some physical health risk factors - such as smoking - have been shown to increase the probability of a frank onset of psychosis in those at risk. A meta-analysis conducted in psychotic patients confirmed that daily tobacco use is associated with an increased risk of psychosis. A significant association between any attenuated psychotic symptoms (that characterize CHR state) and cigarette smoking has been recently shown in a study conducted in South London. Nowadays, it is not completely clear how these findings would translate to the CHR population but a better understanding of how physical health parameters could affect psychopathological outcomes could be beneficial for these vulnerable clinical populations. To shed light on the percentage of smokers in CHR populations, an updated systematic review and meta-analysis of the literature has been carried out. Our main aim was to test whether the probability of being a smoker was higher in the CHR subjects or in the control group. Methods The literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We systematically scrutinized from literature inception to 2019 the following on-line databases: Web of Science Core Collection, BIOSIS Citation Index, KCL-Korean Journal Database, MEDLINE, Russian Science Citation Index, SCiELO Citation Index. We have considered all the relevant studies reporting the smoking status in CHR subjects and in control groups. We used the odds ratio (OR) as effect size measure and data were pooled using a random effect approach. Results Preliminary data show that CHR individuals were more likely to use tobacco that matched healthy controls. Specifically, the overall OR of 2.016 (p<.001 95%CI=1.476–2.749) indicated a higher likelihood that CHR individuals would use tobacco compared to controls. Heterogeneity was not significant (I²=30.193 p=0.11). The visual inspection of funnel plots did not reveal a clear suggestion for publication bias and the Egger’s test was non-significant (p=0.10). Discussion Our systematic review and meta-analysis suggest that is crucial to investigate physical health outcomes such as tobacco use as part of clinical practice in CHR services. Unfortunately, current CHR assessment tools are entirely based on the measurement of psychopathological features and do not include an assessment of these parameters on a regular basis.

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The neurobiology of suicide in psychosis: A systematic review

Journal of Psychopharmacology ◽

10.1177/0269881120936919 ◽

2020 ◽

Vol 34 (8) ◽

pp. 811-819 ◽

Cited By ~ 1

Author(s):

Ragy R Girgis

Keyword(s):

Systematic Review ◽

High Risk ◽

General Population ◽

Lifetime Risk ◽

First Year ◽

Positive Symptoms ◽

Clinical High Risk ◽

Severe Problem ◽

Work Done ◽

The Relationship

The lifetime risk of dying by suicide in schizophrenia and related psychoses has been estimated to be approximately between 5% and 7%, though some have estimated that the number is closer to 10%. The highest risk for suicide occurs within the first year after presentation, when patients have a 12 times greater risk of dying by suicide than the general population, or a 60% higher risk compared with patients in other phases of psychosis, although the risk continues for many years. Some 31% of all deaths in first and early episode samples are due to suicide. Studies in individuals at clinical high-risk for psychosis (CHR) or with attenuated positive symptoms also demonstrate that suicidality is common and problematic in these individuals. Therefore, suicide in psychosis is a particularly severe problem. In order to develop interventions aimed at reducing the risk of suicide in psychotic individuals, it will be critical to understand the neurobiology of suicide in psychosis. In this paper, I report on the results of a systematic review of the work done to date on the neurobiology of suicide in psychosis and on suicidality in the CHR period. I will also identify gaps in knowledge and discuss future strategies for studying the neurobiology of suicidality in psychosis that may help to disentangle the links between suicide and psychosis and, by doing so, allow us to gain a greater understanding of the relationship between suicide and psychosis, which is critical for developing interventions aimed at reducing the risk of suicide in psychotic individuals.

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