TY - JOUR
T1 - Federated multi-site longitudinal study of at-risk mental state for psychosis in Japan
AU - Matsumoto, Kazunori
AU - Katsura, Masahiro
AU - Tsujino, Naohisa
AU - Nishiyama, Shimako
AU - Nemoto, Takahiro
AU - Katagiri, Naoyuki
AU - Takahashi, Tsutomu
AU - Higuchi, Yuko
AU - Ohmuro, Noriyuki
AU - Matsuoka, Hiroo
AU - Suzuki, Michio
AU - Mizuno, Masafumi
N1 - Funding Information:
This work was supported by Health and Labour Sciences Research Grants for Comprehensive Research on Persons with Disabilities from the Japan Agency for Medical Research and Development ( AMED ) to KM, MS, TK, and MM, and the Ministry of Education, Culture, Sports, Science and Technology ( MEXT ) Grants-in-Aid for Scientific Research ( KAKENHI ) Grant Numbers: 17790803 , 19591336 , 22390219 , 24390281 , and 25461747 . This work was also partially supported by a grant for Comprehensive Research on Disability Health and Welfare ( H23-SEISHIN-IPPAN-009 ) from the Ministry of Health Labour and Welfare, Japan .
Publisher Copyright:
© 2018 Elsevier B.V.
PY - 2019/2
Y1 - 2019/2
N2 - There has been recent accumulation of evidence and clinical guidance regarding the at-risk mental state (ARMS) for psychosis. However, most studies have been observational cohort and intervention studies of Western populations. To assess the validity of the ARMS concept and the transition rate to psychosis in a non-Western nation, we retrospectively combined and analyzed clinical data of individuals diagnosed with ARMS who were prospectively followed-up at three specialized clinical services for ARMS in Japan. In total, we included 309 individuals with ARMS, of whom 43 developed overt psychosis. We estimated cumulative transition rates to psychosis with the Kaplan-Meier method, obtaining rates of 12% at 12, 16% at 24, 19% at 36, and 20% at 48 months. Only two individuals reported past cannabis use. Despite several differences among the three sites, transition rates did not differ among them. Furthermore, the transition rate of children aged between 14 and 17 years did not differ from that of individuals aged 18 years or older. Regression analysis revealed that meeting the brief limited intermittent psychotic symptoms (BLIPS) criterion was associated with an increased risk of transition to psychosis, whereas genetic risk factors were not. Although antipsychotic prescription was relatively frequent in this cohort, there was no evidence supporting frequent use of antipsychotics for this population. In conclusion, our findings support the assertion that the current concept of ARMS is applicable in Japan. Development of local clinical guidelines and training for clinicians is necessary to disseminate this concept to more clinical settings.
AB - There has been recent accumulation of evidence and clinical guidance regarding the at-risk mental state (ARMS) for psychosis. However, most studies have been observational cohort and intervention studies of Western populations. To assess the validity of the ARMS concept and the transition rate to psychosis in a non-Western nation, we retrospectively combined and analyzed clinical data of individuals diagnosed with ARMS who were prospectively followed-up at three specialized clinical services for ARMS in Japan. In total, we included 309 individuals with ARMS, of whom 43 developed overt psychosis. We estimated cumulative transition rates to psychosis with the Kaplan-Meier method, obtaining rates of 12% at 12, 16% at 24, 19% at 36, and 20% at 48 months. Only two individuals reported past cannabis use. Despite several differences among the three sites, transition rates did not differ among them. Furthermore, the transition rate of children aged between 14 and 17 years did not differ from that of individuals aged 18 years or older. Regression analysis revealed that meeting the brief limited intermittent psychotic symptoms (BLIPS) criterion was associated with an increased risk of transition to psychosis, whereas genetic risk factors were not. Although antipsychotic prescription was relatively frequent in this cohort, there was no evidence supporting frequent use of antipsychotics for this population. In conclusion, our findings support the assertion that the current concept of ARMS is applicable in Japan. Development of local clinical guidelines and training for clinicians is necessary to disseminate this concept to more clinical settings.
KW - Clinical high risk
KW - Early intervention
KW - Prevention
KW - Schizophrenia
KW - Ultra-high risk
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U2 - 10.1016/j.schres.2018.09.001
DO - 10.1016/j.schres.2018.09.001
M3 - Article
C2 - 30219604
AN - SCOPUS:85053146392
VL - 204
SP - 343
EP - 352
JO - Schizophrenia Research
JF - Schizophrenia Research
SN - 0920-9964
ER -