ArticleSchizophrenia (Heidelberg, Germany)2022
Antipsychotic prescription, assumption and conversion to psychosis: resolving missing clinical links to optimize prevention through precision.
Article in Schizophrenia (Heidelberg, Germany), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 18 citations in OpenAlex.
- Exposure to Antipsychotics in Youths at Clinical High Risk for Psychosis: Low VS High Doses and Their Relevance for Clinical Outcomes.Early intervention in psychiatry · 2026Article
- Distinct brain volume abnormalities in clinical high-risk individuals: pre- and post-antipsychotic treatment.Psychological medicine · 2026Article
- Cytokine changes in clinical high risk for psychosis population following antipsychotic medication.Translational psychiatry · 2026Article
- Risk-Stratified Tiered Intervention Among Chinese Clinical High-Risk for Psychosis Patients and Attenuated Negative Symptoms as a Predictor of 1-Year Psychosis Conversion: A Retrospective Propensity-Matched Real-World Cohort Study.Neuropsychiatric disease and treatment · 2026Article
- Transient pre-baseline antipsychotic exposure (TPAE) is a prognostic specifier in clinical high risk for psychosis: evidence from the PSYSCAN consortium study.Schizophrenia (Heidelberg, Germany) · 2025Article
- Prediction of antipsychotic medication inception in antipsychotic-naive youth at clinical high risk for psychosis.Psychological medicine · 2025Observational
- Targeting Psychotic and Cognitive Dimensions in Clinical High Risk for Psychosis (CHR-P): A Narrative Review.Journal of clinical medicine · 2025Review
- Timeframe for Conversion to Psychosis From Individuals at Clinical High-Risk: A Quantile Regression.Schizophrenia bulletin · 2025Article
- Neurocognitive resilience as a predictor of psychosis onset and functional outcomes in individuals at high risk.BMC medicine · 2025Article
- Advancements and Future Directions in Prevention Based on Evaluation for Individuals With Clinical High Risk of Psychosis: Insights From the SHARP Study.Schizophrenia bulletin · 2025Review
- Subgroups of Clinical High Risk for Psychosis Based on Baseline Antipsychotic Exposure: Clinical and Outcome Comparisons Across a 2-Year Follow-up Period.Schizophrenia bulletin · 2025Article
- Cognitive functions following initiation of antipsychotic medication in adolescents and adults at clinical high risk for psychosis: a naturalistic sub group analysis using the MATRICS consensus cognitive battery.Child and adolescent psychiatry and mental health · 2024Article
- Comprehensive review of multidimensional biomarkers in the ShangHai At Risk for Psychosis (SHARP) program for early psychosis identification.PCN reports : psychiatry and clinical neurosciences · 2023Review
- Detecting at-risk mental states for psychosis (ARMS) using machine learning ensembles and facial features.Schizophrenia research · 2023Article
- Symptoms of Attenuated Psychosis Syndrome in Relatives of Clinical High-Risk Youth: Preliminary Evidence.Schizophrenia bulletin · 2023Article
Corrections and comments
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Authors and funding
14 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The current concept of clinical high-risk(CHR) of psychosis relies heavily on "below-threshold" (i.e. attenuated or limited and intermittent) psychotic positive phenomena as predictors of the risk for future progression to "above-threshold" positive symptoms (aka "transition" or "conversion"). Positive symptoms, even at attenuated levels are often treated with antipsychotics (AP) to achieve clinical stabilization and mitigate the psychopathological severity. The goal of this study is to contextually examine clinicians' decision to prescribe AP, CHR individuals' decision to take AP and psychosis conversion risk in relation to prodromal symptoms profiles. CHR individuals (n = 600) were recruited and followed up for 2 years between 2016 and 2021. CHR individuals were referred to the participating the naturalistic follow-up study, which research procedure was independent of the routine clinical treatment. Clinical factors from the Structured Interview for Prodromal Syndromes (SIPS) and global assessment of function (GAF) were profiled via exploratory factor analysis (EFA), then the extracted factor structure was used to investigate the relationship of prodromal psychopathology with clinicians' decisions to AP-prescription, CHR individuals' decisions to AP-taking and conversion to psychosis. A total of 427(71.2%) CHR individuals were prescribed AP at baseline, 532(88.7%) completed the 2-year follow-up, 377(377/532, 70.9%) were taken AP at least for 2 weeks during the follow-up. EFA identified six factors (Factor-1-Negative symptoms, Factor-2-Global functions, Factor-3-Disorganized communication & behavior, Factor-4-General symptoms, Factor-5-Odd thoughts, and Factor-6-Distorted cognition & perception). Positive symptoms (Factor-5 and 6) and global functions (Factor-2) factors were significant predictors for clinicians' decisions to AP-prescription and CHR individuals' decisions to assume AP, whereas negative symptoms (Factor-1) and global functions (Factor-2) factors predicted conversion. While decisions to AP-prescription, decisions to AP-taking were associated to the same factors (positive symptoms and global functions), only one of those was predictive of conversion, i.e. global functions. The other predictor of conversion, i.e. negative symptoms, did not seem to be contemplated both on the clinician and patients' sides. Overall, the findings indicated that a realignment in the understanding of AP usage is warranted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.