Study Of Psychological Status And Follow-up In Individuals At High-risk For Psychosis

Objective:Evidence for psychological risk factors on prodromal state of psychosis remained limited and inconsistent.This study aimed to investigate childhood trauma,life events and social support in subjects with high risk for psychosis(HR),first episode psychosis with schizophrenia(FEP)and healthy control(HC).Then to explore the differences in psychological characteristics of the three groups,understanding the role of psychological factors in the transformation mechanism of individuals at high-risk for psychosis.Methods:In the study,56 FEP,83 HR and 61 HC underwent face-to-face clinical interview,psychological assessment and cognitive assessment.Clinical information collecting included general socio-demographic data,Mini International Neuropsychiatric Interview(MINI),Structured Interview for Prodromal Syndromes(SIPS),Positive and Negative Syndrome Scale(PANSS),Montgomery-Asberg Depression Rating.Scale(MADRS)and Global Assessment Function(GAF).Psychological scales included Childhood Trauma Questionnaire(CTQ),Life Events Scale(LES)and Perceived Social Support Scale(PSSS).Cognitive scales included Trail Making Test-A(TMT-A),Digit Symbol Coding Test(DST),Hopkins Verbal Leaning Test-Revised(HVLT-R),Brief Visuospatial Memory Test Revised(BVMT-R),Stroop Color Word Test(SCWT)and Continuous Performance Test(CPT).Results:1.Symptomatic comparison results:FEP and HR groups had significant differences inPANSS total score and all PANSS subscale scores(p<0.001).There were significant differences in total SIPS scores and all SIPS subscale scores between HR and HC groups(p<0.05).FEP group had the lowest GAF score and the highest MADRS score,while HC group had the highest GAF score and the lowest MADRS score.The GAF and MADRS scores of the HR group were between the other two groups.In ANCOVA analysis,after controlling for socio-demographic variables(including age,education,marriage and employment)with statistical differences in the univariate analysis,PANSS total score(F=96.6,P<0.001),SIPS total score(F=8.8,P=0.003),SIPS positive scale score(F=11.9,P=0.001),GAF total score(F=120.5,P<0.001)and MADRS total score(F=46.6,P<0.001)were still statistically significant in the three groups.2.Psychological comparison results:The results showed that in univariate analysis,HR individuals had more childhood trauma,more recent life events and less social support than HC group,meanwhile these findings were also supported by ANCOVA analysis except for the results related to social support(taking age,education,marital and employment status as covariates).Logistic regression analysis revealed that HR group was significantly associated with more childhood trauma,poorer overall function and unmarried state than HC group.3.Cognitive comparison results:Combined with our institute's earlier collection of data in 2015,after 2 years of follow-up,we found that in HR people(including unltra-high risk for psychosis(UHR)and first-degree relatives with schizophrenia(FDR)),its baseline cognitive test scores minus 2 years follow-up'^scores was statistically difference in the following aspects:(1)HVLT-R:(P=0.04,mean—2.25).(2)CPT:(P=0.03,mean =-0.31);(3)Stroop word test:(P=0.04,mean=-4.45).In addition,there were no statistically significant differences in TMT-A,DST,BVMT-R,Stroop color test and Stroop word and color test between baseline and 2 years of follow-up.Conclusion:HR individuals experienced more childhood trauma,life events and social support deficit than HC individuals,which may be risk factors of conversion to psychosis and relate to deterioration in overall function.Further explorations are warranted to develop optimal psychosocial interventions.