CONVERSION STUDY OF A CHINESE SAMPLE AT CLINICAL-HIGH-RISK FOR PSYCHOSIS
Authors: Mao *Zhen , Bo Qijing , Dong Fang , Wang Chuanyue 
Published: February 2025

Background

The early detection and intervention of Clinical High Risk (CHR) for psychosis, along with a clear understanding of its natural course, can significantly reduce the risk and minimize the onset of full-blown psychosis, thereby improving overall prognosis (Pablo et al., 2021). Internationally, the early identification and follow-up of individuals at CHR for psychosis have become increasingly sophisticated, while in China, the initiation of such efforts has been relatively late.

Objective

To determine the conversion risk by conducting long-term follow-up of individuals at CHR for psychosis in China.

Methods

70 CHR individuals through the Structured Interview for Prodromal Syndromes (SIPS) screening were included in Beijing Anding Hospital Affiliated to Capital Medical University from January 2015 to August 2019. 3 follow-ups were conducted from March 2017 to January 2018, March to December 2019, and June 2022. Determine conversion and diagnosis according to SIPS and the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) standards respectively.

Results

60 CHR individuals were followed for a mean time of 41.82 months (range 3-86 months). Among them, 23 cases were converted, 37 cases were unconverted, and the median conversion time was 14 months (range 3-34 months). Survival analysis showed a conversion rate of 25% at 1 year, 30% at 2 years, and 36% at 3 years.

Discussion & Conclusion

80-90% of individuals experience risk symptoms in the 6 months to 3 years prior to the onset of psychosis. In the year preceding onset, particularly in the last 4-6 months, there is an increase in both the number and intensity of symptoms (Varsamis and Adamson, 1971). The findings of this study are consistent with large-scale cohort studies both domestically and internationally, the conversion from CHR to psychosis is concentrated in the first 3 years of onset, and about 36% of individuals are converted to mental disorders such as schizophrenia and bipolar disorder (Zhang et al., 2017, Nelson et al., 2013, Cannon et al., 2008).

References

1.CANNON, T. D., CADENHEAD, K., CORNBLATT, B., WOODS, S. W., ADDINGTON, J., WALKER, E., SEIDMAN, L. J., PERKINS, D., TSUANG, M., MCGLASHAN, T. &HEINSSEN, R. 2008. Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Archives of general psychiatry, 65, 28-37.

2.NELSON, B., YUEN, H. P., WOOD, S. J., LIN, A., SPILIOTACOPOULOS, D., BRUXNER, A., BROUSSARD, C., SIMMONS, M., FOLEY, D. L., BREWER, W. J., FRANCEY, S. M., AMMINGER, G. P., THOMPSON, A., MCGORRY, P. D. &YUNG, A. R. 2013. Long-term follow-up of a group at ultra high risk ("prodromal") for psychosis: the PACE 400 study. JAMA psychiatry, 70, 793-802.

3.PABLO, G. S. D., RADUA, J., PEREIRA, J., BONOLDI, I., ARIENTI, V., BESANA, F., SOARDO, L., CABRAS, A., FORTEA, L., CATALAN, A., VAQUERIZO-SERRANO, J., CORONELLI, F., KAUR, S., SILVA, J. D., SHIN, J. I., SOLMI, M., BRONDINO, N., POLITI, P., MCGUIRE, P. &FUSAR-POLI, P. 2021. Probability of Transition t Posychosis in Individuals at Clinical High Risk: An Updated Meta-analysis. JAMA psychiatry, 78, 970-978.

4.VARSAMIS, J. &ADAMSON, J. D. 1971. Early schizophrenia. Can Psychiatr Assoc J, 16, 487-97.

5.ZHANG, T. H., LI, H. J., WOODBERRY, K. A., XU, L. H., TANG, Y. Y., GUO, Q., CUI, H. R., LIU, X. H., CHOW, A., LI, C. B., JIANG, K. D., XIAO, Z. P., SEIDMAN, L. J. &WANG, J. J. 2017. Two-year follow-up of a Chinese sample at clinical high risk for psychosis: timeline of symptoms, help-seeking and conversion. Epidemiology psychiatric sciences, 26, 287-298.