PMID- 32436725
OWN - NLM
STAT- MEDLINE
DCOM- 20210712
LR  - 20220105
IS  - 1440-1614 (Electronic)
IS  - 0004-8674 (Linking)
VI  - 54
IP  - 7
DP  - 2020 Jul
TI  - Real-world effectiveness of antipsychotic treatment in psychosis prevention in a 
      3-year cohort of 517 individuals at clinical high risk from the SHARP (ShangHai 
      At Risk for Psychosis).
PG  - 696-706
LID - 10.1177/0004867420917449 [doi]
AB  - OBJECTIVE: Antipsychotics are widely used for treating psychosis, but it is 
      unclear whether they can also prevent psychosis. This study attempted a 
      longitudinal evaluation of antipsychotics under real-world conditions in China to 
      evaluate their effect on the rate of conversion to psychosis in individuals with 
      a clinical high risk (CHR) of psychosis. METHOD: A total of 517 CHR individuals 
      were recruited between 2011 and 2016 and followed up for 3 years. Among these, 
      450 (87.0%) individuals completed follow-up, 108 (24.0%) showed conversion to 
      psychosis and 309 (68.7%) received antipsychotics. The main outcome was 
      conversion to psychosis. The sample was further stratified according to the 
      severity of positive symptoms. RESULTS: Patients who did not receive 
      antipsychotics showed a lower conversion rate than those who did (17.7% vs 26.9%; 
      odds ratio [OR] = 0.660, 95% confidence interval [CI] = [0.442, 0.985], p = 
      0.035). In mild CHR cases, antipsychotic treatment was more likely to be 
      associated with conversion to psychosis, compared with the no-antipsychotics 
      group, with no such difference observed in severe CHR cases. Among those who 
      received antipsychotics, monotherapy or low-dose treatment was associated with 
      lower conversion rates. Our results did not favor any specific type of 
      antipsychotics and suggested that a very small subgroup of CHR individuals with 
      severe positive and general symptoms but mild negative symptoms may benefit from 
      antipsychotic treatment. CONCLUSIONS: Administration of antipsychotics to CHR 
      patients is potentially harmful with no preventive benefits. We do not recommend 
      antipsychotic treatment for CHR individuals, which is practiced widely in China, 
      and strongly advise caution if these drugs are used.
FAU - Zhang, TianHong
AU  - Zhang T
AUID- ORCID: 0000-0002-5379-7119
AD  - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, 
      Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
FAU - Xu, LiHua
AU  - Xu L
AD  - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, 
      Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
FAU - Tang, XiaoChen
AU  - Tang X
AD  - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, 
      Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
FAU - Wei, YanYan
AU  - Wei Y
AD  - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, 
      Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
FAU - Hu, Qiang
AU  - Hu Q
AD  - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, 
      Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
FAU - Hu, YeGang
AU  - Hu Y
AD  - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, 
      Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
FAU - Cui, HuiRu
AU  - Cui H
AD  - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, 
      Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
FAU - Tang, YingYing
AU  - Tang Y
AD  - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, 
      Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
FAU - Hui, Li
AU  - Hui L
AD  - Institute of Mental Health, The Affiliated Guangji Hospital of Soochow 
      University, Soochow University, Suzhou, P.R. China.
FAU - Li, ChunBo
AU  - Li C
AD  - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, 
      Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
FAU - Cao, LiPing
AU  - Cao L
AD  - Department of Early Intervention, Affiliated Brain Hospital of Guangzhou Medical 
      University (Guangzhou Huiai Hospital), Guangdong Engineering Technology Research 
      Center for Translational Medicine of Mental Disorders, Guangzhou, P.R. China.
FAU - Lu, Zheng
AU  - Lu Z
AD  - Department of Psychiatry, School of Medicine, Tongji Hospital, Tongji University, 
      Shanghai, P.R. China.
FAU - Wang, JiJun
AU  - Wang J
AD  - Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, 
      Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
AD  - CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), 
      Chinese Academy of Science, China.
AD  - Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, 
      Shanghai, PR China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200521
PL  - England
TA  - Aust N Z J Psychiatry
JT  - The Australian and New Zealand journal of psychiatry
JID - 0111052
RN  - 0 (Antipsychotic Agents)
SB  - IM
CIN - Aust N Z J Psychiatry. 2022 Jan;56(1):97. PMID: 33971747
MH  - Adolescent
MH  - Adult
MH  - Antipsychotic Agents/*therapeutic use
MH  - China
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prodromal Symptoms
MH  - Psychotic Disorders/*drug therapy/*prevention & control
MH  - Risk Assessment
MH  - Young Adult
OTO - NOTNLM
OT  - Ultra high risk
OT  - antipsychotic
OT  - outcome
OT  - prodromal psychosis
OT  - transition
EDAT- 2020/05/22 06:00
MHDA- 2021/07/13 06:00
CRDT- 2020/05/22 06:00
PHST- 2020/05/22 06:00 [pubmed]
PHST- 2021/07/13 06:00 [medline]
PHST- 2020/05/22 06:00 [entrez]
AID - 10.1177/0004867420917449 [doi]
PST - ppublish
SO  - Aust N Z J Psychiatry. 2020 Jul;54(7):696-706. doi: 10.1177/0004867420917449. 
      Epub 2020 May 21.