SynthesisTranslational psychiatry2023
The temporal dynamics of transition to psychosis in individuals at clinical high-risk (CHR-P) shows negative prognostic effects of baseline antipsychotic exposure: a meta-analysis.
Synthesis in Translational psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Familial high-risk (FHR) for severe mental illness in clinical high-risk for psychosis (CHR-P): a systematic review and meta-analysis.European archives of psychiatry and clinical neuroscience · 2026Pooled it
- 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
- Connecting the empirical dots on antipsychotic exposure and treatment in clinical high-risk for psychosis.Psychological medicine · 2025Article
- 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
- Targeting Psychotic and Cognitive Dimensions in Clinical High Risk for Psychosis (CHR-P): A Narrative Review.Journal of clinical medicine · 2025Review
- Increasing conceptual clarity and confounders identification: a pragmatic way to enhance prognostic precision in ENIGMA clinical high risk for psychosis (CHR-P).Molecular psychiatry · 2025Article
- The impact of aripiprazole on neurocognitive function in individuals at clinical high risk for psychosis: A comparison with olanzapine and non-antipsychotic treatment.European psychiatry : the journal of the Association of European Psychiatrists · 2025Article
- Body fluid biomarkers and psychosis risk in The Accelerating Medicines Partnership® Schizophrenia Program: design considerations.Schizophrenia (Heidelberg, Germany) · 2025Article
- 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
- Baseline Exposure to Antipsychotic Medication in Young People at Clinical High Risk for Psychosis: A 2-Year Italian Follow-Up Study.Human psychopharmacology · 2025Article
- Diagnostic shift in adolescents with first episode psychosis: findings from the 2-year follow-up of the "Parma Early Psychosis" program.Social psychiatry and psychiatric epidemiology · 2025Article
- Article
- Disrupted coherence between autonomic activation and emotional expression in individuals at clinical high risk for psychosis.Journal of psychopathology and clinical science · 2024Article
- Antipsychotic Treatment in People at Clinical High Risk for Psychosis: A Narrative Review of Suggestions for Clinical Practice.Journal of clinical psychopharmacologyReview
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Meta-analytic evidence indicates that baseline exposure to antipsychotics (AP) in individuals at clinical high-risk for psychosis (CHR-P) is associated with an even higher risk of transition to psychosis. However, the temporal dynamics of such prognostic effect have not been clarified yet. This study was therefore designed to address this knowledge gap. We performed a systematic review and meta-analysis of all longitudinal studies published up to 31 December 2021 on CHR-P individuals identified according to a validated diagnostic procedure and reporting numeric data of transition to psychosis according to baseline antipsychotic exposure. 28 studies covering a total of 2405 CHR-P were included. 554 (23.0%) were exposed to AP at baseline, whereas 1851 (77.0%) were not. At follow-up (12 to 72 months), 182 individuals among AP-exposed (32.9%; 95% CI: 29.4% to 37.8%) and 382 among AP-naive CHR-P (20.6%; 18.8% to 22.8%) developed psychosis. Transition rates increased over time, with the best-fit for an ascending curve peaking at 24 months and reaching then a plateau, with a further increase at 48 months. Baseline AP-exposed CHR-P had higher transition risk at 12 months and then again at 36 and 48 months, with an overall higher risk of transition (fixed-effect model: risk ratio = 1.56 [95% CI: 1.32-1.85]; z = 5.32; p < 0.0001; Random-effect model: risk ratio = 1.56 [95% CI: 1.07-2.26]; z = 2.54; p = 0.0196). In conclusion, the temporal dynamics of transition to psychosis differ in AP-exposed vs. AP-naive CHR-P. Baseline AP exposure in CHR-P is associated with a persistently higher risk of transition at follow up, supporting the rationale for more stringent clinical monitoring in AP-exposed CHR-P. The insufficiency of more granular information in available primary literature (e.g., temporal and quantitative details of AP exposure as well as psychopathological dimensions in CHR-P) did not allow the testing of causal hypotheses on this negative prognostic association.
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