Three-year course of clinical high-risk symptoms for psychosis in the community: a latent class analysis
Abstract Aims Clinical high-risk for psychosis (CHR-P) states exhibit diverse clinical presentations, prompting a shift towards broader outcome assessments beyond psychosis manifestation. To elucidate more uniform clinical profiles and their trajectories, we investigated CHR-P profiles in a communit...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2025-01-01
|
| Series: | Epidemiology and Psychiatric Sciences |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2045796024000891/type/journal_article |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841526397749690368 |
|---|---|
| author | C. Michel N. Osman G. Rinaldi B. G. Schimmelmann J. Kindler F. Schultze-Lutter |
| author_facet | C. Michel N. Osman G. Rinaldi B. G. Schimmelmann J. Kindler F. Schultze-Lutter |
| author_sort | C. Michel |
| collection | DOAJ |
| description | Abstract
Aims
Clinical high-risk for psychosis (CHR-P) states exhibit diverse clinical presentations, prompting a shift towards broader outcome assessments beyond psychosis manifestation. To elucidate more uniform clinical profiles and their trajectories, we investigated CHR-P profiles in a community sample.
Methods
Participants (N = 829; baseline age: 16–40 years) comprised individuals from a Swiss community sample who were followed up over roughly 3 years. latent class analysis was applied to CHR-P symptom data at baseline and follow-up, and classes were examined for demographic and clinical differences, as well as stability over time.
Results
Similar three-class solutions were yielded for both time points. Class 1 was mainly characterized by subtle, subjectively experienced disturbances in mental processes, including thinking, speech and perception (basic symptoms [BSs]). Class 2 was characterized by subthreshold positive psychotic symptoms (i.e., mild delusions or hallucinations) indicative of an ultra-high risk for psychosis. Class 3, the largest group (comprising over 90% of participants), exhibited the lowest probability of experiencing any psychosis-related symptoms (CHR-P symptoms). Classes 1 and 2 included more participants with functional impairment and psychiatric morbidity. Class 3 participants had a low probability of having functional deficits or mental disorders at both time points, suggesting that Class 3 was the healthiest group and that their mental health and functioning remained stable throughout the study period. While 91% of Baseline Class 3 participants remained in their class over time, most Baseline Classes 1 (74%) and Class 2 (88%) participants moved to Follow-up Class 3.
Conclusions
Despite some temporal fluctuations, CHR-P symptoms within community samples cluster into distinct subgroups, reflecting varying levels of symptom severity and risk profiles. This clustering highlights the largely distinct nature of BSs and attenuated positive symptoms within the community. The association of Classes 1 and 2 with Axis-I disorders and functional deficits emphasizes the clinical significance of CHR-P symptoms. These findings highlight the need for personalized preventive measures targeting specific risk profiles in community-based populations.
|
| format | Article |
| id | doaj-art-0b961caef36b4caaafd5d49c037670a6 |
| institution | Kabale University |
| issn | 2045-7960 2045-7979 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Epidemiology and Psychiatric Sciences |
| spelling | doaj-art-0b961caef36b4caaafd5d49c037670a62025-01-16T21:53:14ZengCambridge University PressEpidemiology and Psychiatric Sciences2045-79602045-79792025-01-013410.1017/S2045796024000891Three-year course of clinical high-risk symptoms for psychosis in the community: a latent class analysisC. Michel0https://orcid.org/0000-0003-1165-6681N. Osman1https://orcid.org/0000-0001-9761-0099G. Rinaldi2https://orcid.org/0009-0006-1644-8020B. G. Schimmelmann3J. Kindler4F. Schultze-Lutter5https://orcid.org/0000-0003-1956-9574University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, SwitzerlandDepartment of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, GermanyUniversity Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, SwitzerlandUniversity Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg-Eppendorf, Hamburg, GermanyUniversity Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland Child and Adolescent Psychiatry, Psychiatry Baselland, Liestal, SwitzerlandUniversity Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, IndonesiaAbstract Aims Clinical high-risk for psychosis (CHR-P) states exhibit diverse clinical presentations, prompting a shift towards broader outcome assessments beyond psychosis manifestation. To elucidate more uniform clinical profiles and their trajectories, we investigated CHR-P profiles in a community sample. Methods Participants (N = 829; baseline age: 16–40 years) comprised individuals from a Swiss community sample who were followed up over roughly 3 years. latent class analysis was applied to CHR-P symptom data at baseline and follow-up, and classes were examined for demographic and clinical differences, as well as stability over time. Results Similar three-class solutions were yielded for both time points. Class 1 was mainly characterized by subtle, subjectively experienced disturbances in mental processes, including thinking, speech and perception (basic symptoms [BSs]). Class 2 was characterized by subthreshold positive psychotic symptoms (i.e., mild delusions or hallucinations) indicative of an ultra-high risk for psychosis. Class 3, the largest group (comprising over 90% of participants), exhibited the lowest probability of experiencing any psychosis-related symptoms (CHR-P symptoms). Classes 1 and 2 included more participants with functional impairment and psychiatric morbidity. Class 3 participants had a low probability of having functional deficits or mental disorders at both time points, suggesting that Class 3 was the healthiest group and that their mental health and functioning remained stable throughout the study period. While 91% of Baseline Class 3 participants remained in their class over time, most Baseline Classes 1 (74%) and Class 2 (88%) participants moved to Follow-up Class 3. Conclusions Despite some temporal fluctuations, CHR-P symptoms within community samples cluster into distinct subgroups, reflecting varying levels of symptom severity and risk profiles. This clustering highlights the largely distinct nature of BSs and attenuated positive symptoms within the community. The association of Classes 1 and 2 with Axis-I disorders and functional deficits emphasizes the clinical significance of CHR-P symptoms. These findings highlight the need for personalized preventive measures targeting specific risk profiles in community-based populations. https://www.cambridge.org/core/product/identifier/S2045796024000891/type/journal_articleclinical profilescommunitycoursegeneral populationlatent class analysismovementoutcomepsychosis risk |
| spellingShingle | C. Michel N. Osman G. Rinaldi B. G. Schimmelmann J. Kindler F. Schultze-Lutter Three-year course of clinical high-risk symptoms for psychosis in the community: a latent class analysis Epidemiology and Psychiatric Sciences clinical profiles community course general population latent class analysis movement outcome psychosis risk |
| title | Three-year course of clinical high-risk symptoms for psychosis in the community: a latent class analysis |
| title_full | Three-year course of clinical high-risk symptoms for psychosis in the community: a latent class analysis |
| title_fullStr | Three-year course of clinical high-risk symptoms for psychosis in the community: a latent class analysis |
| title_full_unstemmed | Three-year course of clinical high-risk symptoms for psychosis in the community: a latent class analysis |
| title_short | Three-year course of clinical high-risk symptoms for psychosis in the community: a latent class analysis |
| title_sort | three year course of clinical high risk symptoms for psychosis in the community a latent class analysis |
| topic | clinical profiles community course general population latent class analysis movement outcome psychosis risk |
| url | https://www.cambridge.org/core/product/identifier/S2045796024000891/type/journal_article |
| work_keys_str_mv | AT cmichel threeyearcourseofclinicalhighrisksymptomsforpsychosisinthecommunityalatentclassanalysis AT nosman threeyearcourseofclinicalhighrisksymptomsforpsychosisinthecommunityalatentclassanalysis AT grinaldi threeyearcourseofclinicalhighrisksymptomsforpsychosisinthecommunityalatentclassanalysis AT bgschimmelmann threeyearcourseofclinicalhighrisksymptomsforpsychosisinthecommunityalatentclassanalysis AT jkindler threeyearcourseofclinicalhighrisksymptomsforpsychosisinthecommunityalatentclassanalysis AT fschultzelutter threeyearcourseofclinicalhighrisksymptomsforpsychosisinthecommunityalatentclassanalysis |