Follow-up of subjects labelled with putative pre-psychotic states: Viewed from a transdiagnostic clinical high-at-risk mental state (CHARMS) paradigm

Journal of the Formosan Medical Association

Yi-Ting Lin¹  Chih-Min Liu²  Tzung-Jeng Hwang²  Yi-Ling Chien³  Hai-Gwo Hwu⁴  Chen-Chung Liu⁴  Ming H. Hsieh⁴ 

[1] Corresponding author. Department of Psychiatry, National Taiwan University Hospital, No. 7 Chung Shan South Road, Taipei, 10002, Taiwan. Fax: [phone];Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan;Department of Psychiatry, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan;Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan;

关键词: At-risk mental state;    Follow-up;    Psychosis;    Pluripotent trajectories;    Transdiagnostic paradigm;    Transition;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Follow-up of subjects with putative pre-psychotic states is essential to clarify the transition process to psychosis, while “non-converters” also deserve clinical attention as many may evolve into other psychiatric disorders with diverse outcomes. This study aimed to examine help-seeking individuals who have been labelled at clinical high-risk state but not converting to full-blown psychosis during first two years of follow-up. Methods: A retrospective observational cohort study of help-seeking subjects was conducted by reviewing medical records of participants in a previous early psychosis study at the study hospital between 2006 and 2020. We portrayed those who developed first episode psychosis after first 2-year follow-up in detail, and provided sketches of clinical macrophenotypes other than psychosis emerging from subjects among different risk groups. Results: Among 132 eligible subjects, data of 98 (74.2%) were available for detailed evaluation. Of these, 15 transitioned to first-episode psychosis (11.4%) with time to psychosis from 2 to 11 years, 11 had anxiety spectrum (8.3%), 11 had depressive spectrum (8.3%), 10 had obsessive compulsive (7.6%), 5 had bipolar spectrum disorders (3.8%), 13 had predominantly schizotypal (9.8%) and 4 had other personality traits (3%), and 13 had problems attributable to adjustment or developmental issues (9.8%). Conclusion: Various diagnoses, either full- or sub-threshold, appropriately describe the diverse clinical phenomenology of a cohort presenting with non-specific and/or subthreshold psychotic symptoms. The clinical high-at-risk mental state (CHARMS) paradigm provides a reasonable transdiagnostic approach for orienting clinicians’ attention toward young subjects seeking mental health help at an early stage of illness to potentially pluripotent trajectories.

【 授权许可】

Unknown