精神病临床高危人群的症状和功能改变:一项系统综述和三水平元分析OA北大核心

The symptoms and functional development of individuals at clinical high-risk for psychosis(CHR-P)exhibit considerable heterogeneity.It is important to understand the changes in symptoms and functional outcomes as well as their relationships in this population for early prevention of psychosis.This study conducted a three-level meta-analysis of 54 studies to comprehensively examine the longitudinal changes in various clinical symptoms and functional outcome among CHR-P individuals.We explored the predictive role of baseline symptoms on follow-up functional outcome.The results indicated significant improvements over time in attenuated positive symptoms,negative symptoms,disorganized symptoms,affective symptoms,general symptoms,global function,and role function.However,social function did not show significant improvement.Baseline negative symptoms significantly and negatively predicted follow-up global function,social function,and role function.Baseline disorganized symptoms,affect symptoms and general symptoms significantly and negatively predicted follow-up global function.Moderation analysis revealed that education level significantly moderated the longitudinal changes of attenuated positive symptoms and negative symptoms.Moreover,age,proportion of attenuated positive symptoms(APS)subgroup,and proportion of brief limited intermittent psychotic symptoms(BLIPS)subgroup significantly moderated the longitudinal changes in affective symptoms.This is the first study to examine the changes in specific function and the longitudinal predictive value of symptoms on functioning in CHR-P individuals.Persistence of negative symptoms and the social function impairments are core features of CHR-P individuals.It is necessary to target at negative symptoms in CHR-P individuals for improving their social functioning.