Shared and Unique Clinical Characteristics among Individuals at Clinical High Risk for Psychosis vs. Help-Seeking Controls: Systematic Review and Meta-Analysis
Eleanor Lynch (1), Elif Ozan (1), Katerina Konstas (1), Jonah Loshin (1), Halide Bilge Turkozer (1), Zachary B. Millman (1)
1. Division of Psychotic Disorders, McLean Hospital
The clinical high-risk (CHR) paradigm is used to identify and treat individuals with pre-psychosis symptoms. Systematic description of clinical characteristics among CHR youth vs. help-seeking controls (HSCs)–those who seek CHR assessment but fail to meet criteria–is essential for refining diagnostic criteria and improving risk prediction. Despite numerous individual studies addressing this topic, no systematic review is available. We are conducting a PRISMA-compliant and PROSPERO-registered systematic review on clinical similarities and differences between CHR individuals and HSCs. Of 1678 records identified, 903 abstracts were screened, 94 full-texts reviewed, and 34 included. An additional 7 were identified through bibliographies of related reviews, yielding k = 41 studies. Two independent reviewers are rating study quality and risk of bias using the Newcastle-Ottawa scale. Quantitative data, including symptom severity, global functioning, and differences across HSCs and individuals who do vs. do not transition to psychosis (k = 12) are being extracted and will be meta-analyzed using Hedge’s g effect sizes, Egger’s test and funnel plots for bias, and Q and I2 for heterogeneity. Initial qualitative review of results indicates that positive, negative, disorganized, general, depressive, and anxiety symptom severity is higher in CHR individuals compared to HSCs. This pattern suggests CHR individuals tend to exhibit more severe symptomatology than patients initially suspected of being CHR but who test negative. These results highlight the distinctive challenges CHR youth face and raise questions about the degree of symptom specificity captured by CHR status. We will present our current results and quantitative analyses at the convention.