ArticleEClinicalMedicine2021
Longitudinal outcome of attenuated positive symptoms, negative symptoms, functioning and remission in people at clinical high risk for psychosis: a meta-analysis.
Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 7 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
42 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Quality of life in individuals at clinical high risk for psychosis: A systematic review and meta-analysis.European psychiatry : the journal of the Association of European Psychiatrists · 2026Pooled it
- Review: Efficacy of preventative interventions for children and adolescents at clinical high risk of psychosis - a systematic review and meta-analysis of intervention studies.Child and adolescent mental health · 2025Pooled it
- Longitudinal change in neurocognitive functioning in children and adolescents at clinical high risk for psychosis: a systematic review.European child & adolescent psychiatry · 2024Pooled it
- Racism and psychosis: an umbrella review and qualitative analysis of the mental health consequences of racism.European archives of psychiatry and clinical neuroscience · 2023Pooled it
- Negative symptoms in children and adolescents with early-onset psychosis and at clinical high-risk for psychosis: systematic review and meta-analysis.The British journal of psychiatry : the journal of mental science · 2023Pooled it
- Meta-analytic prevalence of comorbid mental disorders in individuals at clinical high risk of psychosis: the case for transdiagnostic assessment.Molecular psychiatry · 2023Pooled it
- Examining the variability of neurocognitive functioning in individuals at clinical high risk for psychosis: a meta-analysis.Translational psychiatry · 2022Pooled it
- Efficacy and safety of transcutaneous auricular vagus nerve stimulation for patients with treatment-resistant schizophrenia with predominantly negative symptoms: a randomized clinical trial and efficacy sensitivity biomarkers.Molecular psychiatry · 2025Trial
- Psychosocial Interventions, Recovery, and Mediating Mechanisms in Schizophrenia-Spectrum Disorders: A Systematic Review and Meta-Analysis of Longitudinal Studies.Brain sciences · 2026Review
- Dynamic, differentiated clinical trajectories and prediction in clinical high risk for psychosis.Molecular psychiatry · 2026Article
- Mobile Technology for Real-Life Assessment of Positive and Negative Symptoms as well as Stress Among Individuals With Early Psychosis: A Scoping Review.Early intervention in psychiatry · 2026Article
- Real-world comprehensive care of people living with schizophrenia: recommendations across different settings and clinical stages.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026Article
- Feasibility of a Stepped-Care Intervention for Those at Clinical High Risk for Psychosis in the United States.Early intervention in psychiatry · 2026Article
- Differential trajectories of corticostriatal structural connectivity in individuals at clinical high risk for psychosis according to functional outcome.Translational psychiatry · 2025Article
- Longitudinal Trajectories of Clinical Features in Community Youth With Recurrent Psychosis Spectrum Symptoms: Findings From the Philadelphia Neurodevelopmental Cohort.Schizophrenia bulletin · 2025Article
- Do Cognitive Subtypes Exist in People at Clinical High Risk for Psychosis? Results From the EU-GEI Study.Schizophrenia bulletin · 2025Article
- Mental health status of the European population and its determinants: A cross-national comparison study.European psychiatry : the journal of the Association of European Psychiatrists · 2025Article
- IQ and socio-occupational functioning in relation to obsessive-compulsive symptoms severity in a clinical sample of adolescents.Scientific reports · 2025Article
- PSYSCAN multi-centre study: baseline characteristics and clinical outcomes of the clinical high risk for psychosis sample.Schizophrenia (Heidelberg, Germany) · 2025Article
- Pathways to prevention: the Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ) Program.Schizophrenia (Heidelberg, Germany) · 2025Article
Corrections and comments
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Authors and funding
25 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLittle is known about clinical outcomes other than transition to psychosis in people at Clinical High-Risk for psychosis (CHR-P). Our aim was to comprehensively meta-analytically evaluate for the first time a wide range of clinical and functional outcomes beyond transition to psychosis in CHR-P individuals.
methodsPubMed and Web of Science were searched until November 2020 in this PRISMA compliant meta-analysis (PROSPERO:CRD42020206271). Individual longitudinal studies conducted in individuals at CHR-P providing data on at least one of our outcomes of interest were included. We carried out random-effects pairwise meta-analyses, meta-regressions, and assessed publication bias and study quality. Analyses were two-tailed with α=0.05.
findings75 prospective studies were included (n=5,288, age=20.0 years, females=44.5%). Attenuated positive symptoms improved at 12 (Hedges' g=0.753, 95%CI=0.495-1.012) and 24 (Hedges' g=0.836, 95%CI=0.463-1.209), but not ≥36 months (Hedges' g=0.315. 95%CI=-0.176-0.806). Negative symptoms improved at 12 (Hedges' g=0.496, 95%CI=0.315-0.678), but not 24 (Hedges' g=0.499, 95%CI=-0.137-1.134) or ≥36 months (Hedges' g=0.033, 95%CI=-0.439-0.505). Depressive symptoms improved at 12 (Hedges' g=0.611, 95%CI=0.441-0.782) and 24 (Hedges' g=0.583, 95%CI=0.364-0.803), but not ≥36 months (Hedges' g=0.512 95%CI=-0.337-1.361). Functioning improved at 12 (Hedges' g=0.711, 95%CI=0.488-0.934), 24 (Hedges' g=0.930, 95%CI=0.553-1.306) and ≥36 months (Hedges' g=0.392, 95%CI=0.117-0.667). Remission from CHR-P status occurred in 33.4% (95%CI=22.6-44.1%) at 12 months, 41.4% (95%CI=32.3-50.5%) at 24 months and 42.4% (95%CI=23.4-61.3%) at ≥36 months. Heterogeneity across the included studies was significant and ranged from I
interpretationCHR-P individuals improve on symptomatic and functional outcomes over time, but these improvements are not maintained in the longer term, and less than half fully remit. Prolonged duration of care may be needed for this patient population to optimize outcomes.
fundingNone.
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