Annual Research Review: Prevention of psychosis in adolescents – systematic review and meta‐analysis of advances in detection, prognosis and intervention

Background The clinical high-risk state for psychosis (CHR-P) paradigm has facilitated the implementation of psychosis prevention into clinical practice; however, advancements in adolescent CHR-P populations are less established. Methods We performed a PRISMA/MOOSE-compliant systematic review of the Web of Science database, from inception until 7 October 2019, to identify original studies conducted in CHR-P children and adolescents (mean age = 36 months.Interventions: There was not enough evidence to recommend one specific treatment (including cognitive behavioural therapy) over the others (including control conditions) to prevent the transition to psychosis in this population. Randomised controlled trials suggested that family interventions, cognitive remediation and fish oil supplementation may improve cognition, symptoms and functioning. At baseline, 30% of CHR-P adolescents were prescribed antipsychotics and 60% received psychotherapy. Conclusions It is possible to detect and formulate a group-level prognosis in adolescents at risk for psychosis. Future interventional research is required. G.S.d.P. and J.V.S. are supported by the Alicia Koplowitz Foundation. The study has been supported by the Spanish Ministry of Science, Innovation, and Universities, Instituto de Salud Carlos III, European Regional Development Fund 'A way of making Europe,' Centro de Investigacion Biomedica en Red Salud Mental, Madrid Regional Government; and Fundacion Mutua Madrilena. A.C. has received personal fees from Janssen and grant support from the Instituto de Salud Carlos III, Spanish Ministry of Economy and Competitiveness. C.A. has been a consultant to or has received honoraria or grants from Acadia, Angelini, Gedeon Richter, Janssen Cilag, Lundbeck, Otsuka, Roche, Sage, Servier, Shire, Schering Plough, Sumitomo Dainippon Pharma, Sunovion and Takeda. C.M. has acted as consultant or participated in DMC for Janssen, Servier, Lundbeck, Nuvelution, Angelini and Otsuka and has received grant support from European Union Funds and Instituto de Salud Carlos III, Spanish Ministry of Economy and Competitiviness. C.U.C. has been a consultant and/or adviser to or has received honoraria from: Alkermes, Allergan, Angelini, Boehringer-Ingelheim, Gedeon Richter, Gerson Lehrman Group, Indivior, IntraCellular Therapies, Janssen/J&J, LB Pharma, Lundbeck, MedAvante-ProPhase, Medscape, Merck, Neurocrine, Noven, Otsuka, Pfizer, Recordati, Rovi, Servier, Sumitomo Dainippon, Sunovion, Supernus, Takeda and Teva. He has provided expert testimony for Bristol-Myers Squibb, Janssen and Otsuka. He served on a Data Safety Monitoring Board for Boehringer-Ingelheim, Lundbeck, Rovi, Supernus, and Teva. He received royalties from UpToDate and grant support from Janssen and Takeda. He is also a shareholder of LB Pharma. P.F-P. has been a consultant to and received research funds from Lundbeck and received honoraria from Menarini and Angelini