Timeframe for Conversion to Psychosis From Individuals at Clinical High-Risk: A Quantile Regression.

IF 4.8 1区 医学 Q1 PSYCHIATRY
TianHong Zhang, YanYan Wei, XiaoChen Tang, LiHua Xu, YeGang Hu, HaiChun Liu, ZiXuan Wang, Tao Chen, ChunBo Li, JiJun Wang
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Abstract

Background and hypothesis: The time taken for an individual who is at the clinical high-risk (CHR) stage to transition to full-blown psychosis may vary from months to years. This temporal aspect, known as the timeframe for conversion to psychosis (TCP), is a crucial but relatively underexplored dimension of psychosis development.

Study design: The sample consisted of 145 individuals with CHR who completed a 5-year follow-up with a confirmed transition to psychosis within this period. Clinical variables along with functional variables such as the Global Assessment of Function (GAF) score at baseline (GAF baseline) and GAF-drop from the highest score in the past year. The TCP was defined as the duration from CHR identification to psychosis conversion. Participants were categorized into 3 groups based on TCP: "short" (≤6 months, ≤33.3%), "median" (7-17 months, 33.3%-66.6%), and "long" (≥18 months, ≥66.6%). The quantile regression analysis was applied.

Study results: The overall sample had a median TCP of 11 months. Significant differences among the three TCP groups were observed, particularly in GAF-drop (χ2 = 8.806, P = .012), disorganized symptoms (χ2 = 7.071, P = .029), and general symptoms (χ2 = 6.586, P = .037). Greater disorganized symptoms (odds ratio [OR] = 0.824, P = .009) and GAF-drop (OR = 0.867, P = .011) were significantly associated with a shorter TCP, whereas greater general symptoms (OR = 1.198, P = .012) predicted a longer TCP. Quantile regression analysis demonstrated a positive association between TCP and GAF baseline above the 0.7 quantile and a negative association between TCP rank and GAF drop below the 0.5 quantile.

Conclusions: This study underscores the pivotal role of functional characteristics in shaping TCP among individuals with CHR, emphasizing the necessity for a comprehensive consideration of temporal aspects in early prevention efforts.

临床高危人群转为精神病的时间框架:量值回归。
背景与假设:一个人从临床高危(CHR)阶段转变为全面精神病所需的时间可能从数月到数年不等。这个时间方面被称为转化为精神病的时间框架(TCP),是精神病发展过程中的一个重要方面,但相对而言尚未得到充分探索:研究样本包括 145 名完成 5 年随访并在此期间被证实转为精神病的 CHR 患者。临床变量和功能变量,如基线时的全球功能评估(GAF)得分(GAF基线)和GAF从过去一年最高分开始的降幅。TCP定义为从CHR识别到精神病转换的持续时间。根据 TCP 将参与者分为三组:"短 "组(≤6 个月,≤33.3%)、"中 "组(7-17 个月,33.3%-66.6%)和 "长 "组(≥18 个月,≥66.6%)。研究结果采用了量回归分析:总体样本的 TCP 中位数为 11 个月。三个 TCP 组之间存在显著差异,尤其是在 GAF 下降(χ2 = 8.806,P = .012)、紊乱症状(χ2 = 7.071,P = .029)和一般症状(χ2 = 6.586,P = .037)方面。更严重的紊乱症状(几率比 [OR] = 0.824,P = .009)和 GAF 下降(OR = 0.867,P = .011)与更短的 TCP 显著相关,而更严重的一般症状(OR = 1.198,P = .012)则预示着更长的 TCP。量值回归分析表明,TCP 与 GAF 基线高于 0.7 量值之间呈正相关,而 TCP 等级与 GAF 下降低于 0.5 量值之间呈负相关:本研究强调了功能特征在形成慢性阻塞性肺疾病患者 TCP 方面的关键作用,强调了在早期预防工作中全面考虑时间因素的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Schizophrenia Bulletin
Schizophrenia Bulletin 医学-精神病学
CiteScore
11.40
自引率
6.10%
发文量
163
审稿时长
4-8 weeks
期刊介绍: Schizophrenia Bulletin seeks to review recent developments and empirically based hypotheses regarding the etiology and treatment of schizophrenia. We view the field as broad and deep, and will publish new knowledge ranging from the molecular basis to social and cultural factors. We will give new emphasis to translational reports which simultaneously highlight basic neurobiological mechanisms and clinical manifestations. Some of the Bulletin content is invited as special features or manuscripts organized as a theme by special guest editors. Most pages of the Bulletin are devoted to unsolicited manuscripts of high quality that report original data or where we can provide a special venue for a major study or workshop report. Supplement issues are sometimes provided for manuscripts reporting from a recent conference.
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