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Further evidence that antipsychotic medication does not prevent long-term psychosis in higher-risk individuals

Authors :
YeGang Hu
Tianhong Zhang
Chunbo Li
LiHua Xu
YanYan Wei
Junjie Wang
HuiRu Cui
Xiaochen Tang
Zheng Ling
Jijun Wang
Yingying Tang
Source :
European Archives of Psychiatry and Clinical Neuroscience. 272:591-602
Publication Year :
2021
Publisher :
Springer Science and Business Media LLC, 2021.

Abstract

Although existing guidelines have discouraged use of antipsychotics for general clinical high-risk (CHR) individuals, it is unclear if antipsychotics can prevent psychosis in higher-risk population. We aimed to study the comparative real-world effectiveness of antipsychotic treatments for preventing psychosis in higher-risk CHR individuals. A total of 300 CHR individuals were identified using the structured interview for prodromal syndromes (SIPS) and followed the participants for 3 years. In total, 228(76.0%) individuals completed baseline assessments using the NAPLS-2 risk calculator (NAPLS-2-RC), and 210(92.1%) completed the follow-up. The sample was further stratified according to risk level. “Higher-risk” was defined based on the NAPLS-2-RC risk score (≥ 20%) and SIPS positive symptom total scores (≥ 10). The main outcome was conversion to psychosis and poor functional outcomes, defined as a global assessment of function (GAF) score lower than 60 at follow-up. In higher-risk CHR individuals, we found no significant difference in the rate of conversion to psychosis or poor functional outcomes between the antipsychotic and no-antipsychotic groups. Low-risk individuals treated with antipsychotic drugs were more likely exhibit poor functional outcomes compared with the no-antipsychotics group(NAPLS-2-RC estimated risk: χ2 = 8.330, p = 0.004; Positive symptom severity: χ2 = 12.997, p

Details

ISSN :
14338491 and 09401334
Volume :
272
Database :
OpenAIRE
Journal :
European Archives of Psychiatry and Clinical Neuroscience
Accession number :
edsair.doi...........83628bb276fbc22c7c63a94ad1c1a5c9
Full Text :
https://doi.org/10.1007/s00406-021-01331-2