Korean J Schizophr Res.  2024 Oct;27(2):35-48. 10.16946/kjsr.2024.27.2.35.

Recent Insights in the Treatment for Clinical High Risk for Psychosis and Recent Onset Psychosis

• Park S
• Jo YT
• Lee JS
• Lee J
• Park IH

• KMID: 2560353
• DOI: http://doi.org/10.16946/kjsr.2024.27.2.35

Abstract

Objectives
This study aims to assess the effectiveness of early interventions in preventing psychosis transition, promoting remission, and reducing hospitalization rates in individuals at high risk for psychosis and those with recent onset psychosis (ROP).
Methods
A systematic review and meta-analysis were conducted, comparing early intervention strategies such as cognitive-behavioral therapy and psychosocial support to no intervention. The study focused on outcomes related to psychosis transition, remission rates, and prevention of psychiatric hospitalization.
Results
Although only a subset of clinical high risk (CHR) individuals transition to full psychosis, non-pharmacological treatments like cognitive-behavioral therapy are generally recommended as a first-line approach. In ROP patients, early pharmacological treatment reduces relapse rates, while psychosocial interventions aim to improve various functional outcomes. The meta-analysis results of this study did not show a significant reduction in psychosis transition rates with specialized interventions for CHR patients. For ROP patients, early interventions initially reduced hospitalization rates, but this effect was not sustained in mid-term follow-up results.
Conclusion
While early interventions offer short-term benefits in reducing psychosis transition and hospitalization, additional research is needed to determine their long-term effectiveness in functional recovery and overall patient outcomes.

Keyword

Clinical high risk for psychosis; Early intervention; Recent onset psychosis; Schizophrenia; 정신증 고위험군; 조기중재; 조현병; 최근 발병한 정신증

Figure

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  Fig. 1. Flowchart of literature selection.

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  Fig. 2. Conversion rates to psychosis for individuals at clinical high risk over different follow-up periods (i.e., 6 months, 1.5 years, 2-3 years, and 3-4 years) for all types of therapeutic interventions. A: 6 months. B: 1 year. C: 1.5-2 years. D: 3-4 years. EI, early intervention; TAU, treatment-as-usual; CI, confidence interval.

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  Fig. 3. Hospitalization rates for recent onset psychosis at different follow-up periods (i.e., 0.5-1 year and 1.5-2 years) after early intervention. A: 0.5-1 year. B: 1.5-2 years. EI, early intervention; TAU, treatment-as-usual; CI, confidence interval.

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