Prevalence of Individuals at Clinical High-Risk of Psychosis in the General Population and Clinical Samples: Systematic Review and Meta-Analysis

(1) The consistency and magnitude of the prevalence of Clinical High-Risk for Psychosis (CHR-P) individuals are undetermined, limiting efficient detection of cases. We aimed to evaluate the prevalence of CHR-P individuals systematically assessed in the general population or clinical samples. (2) PRI...

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Autores principales:	Gonzalo Salazar de Pablo, Scott W. Woods, Georgia Drymonitou, Héctor de Diego, Paolo Fusar-Poli
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	schizophrenia CHR prevention clinical settings community meta-analytic evidence Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/545c59ffca9b412e8017658a9dd8fc63
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spelling	oai:doaj.org-article:545c59ffca9b412e8017658a9dd8fc632021-11-25T16:59:21ZPrevalence of Individuals at Clinical High-Risk of Psychosis in the General Population and Clinical Samples: Systematic Review and Meta-Analysis10.3390/brainsci111115442076-3425https://doaj.org/article/545c59ffca9b412e8017658a9dd8fc632021-11-01T00:00:00Zhttps://www.mdpi.com/2076-3425/11/11/1544https://doaj.org/toc/2076-3425(1) The consistency and magnitude of the prevalence of Clinical High-Risk for Psychosis (CHR-P) individuals are undetermined, limiting efficient detection of cases. We aimed to evaluate the prevalence of CHR-P individuals systematically assessed in the general population or clinical samples. (2) PRISMA/MOOSE-compliant (PROSPERO: CRD42020168672) meta-analysis of multiple databases until 21/01/21: a random-effects model meta-analysis, heterogeneity analysis, publication bias and quality assessment, sensitivity analysis—according to the gold-standard CHR-P and pre-screening instruments—leave-one-study-out analyses, and meta-regressions were conducted. (3) 35 studies were included, with 37,135 individuals tested and 1554 CHR-P individuals identified (median age = 19.3 years, Interquartile range (IQR) = 15.8–22.1; 52.2% females, IQR = 38.7–64.4). In the general population (k = 13, <i>n</i> = 26,835 individuals evaluated), the prevalence of the CHR-P state was 1.7% (95% Confidence Interval (CI) = 1.0–2.9%). In clinical samples (k = 22, <i>n</i> = 10,300 individuals evaluated), the prevalence of the CHR-P state was 19.2% (95% CI = 12.9–27.7%). Using a pre-screening instrument was associated with false negatives (5.6%, 95% CI = 2.2–13.3%) and a lower CHR-P prevalence (11.5%, 95% CI = 6.2–20.5%) compared to using CHR-P instruments only (28.5%, 95% CI = 23.0–34.7%, <i>p</i> = 0.003). (4) The prevalence of the CHR-P state is low in the general population and ten times higher in clinical samples. The prevalence of CHR-P may increase with a higher proportion of females in the general population and with a younger population in clinical samples. The CHR-P state may be unrecognized in routine clinical practice. These findings can refine detection and preventive strategies.Gonzalo Salazar de PabloScott W. WoodsGeorgia DrymonitouHéctor de DiegoPaolo Fusar-PoliMDPI AGarticleschizophreniaCHRpreventionclinical settingscommunitymeta-analytic evidenceNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENBrain Sciences, Vol 11, Iss 1544, p 1544 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	schizophrenia CHR prevention clinical settings community meta-analytic evidence Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	schizophrenia CHR prevention clinical settings community meta-analytic evidence Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Gonzalo Salazar de Pablo Scott W. Woods Georgia Drymonitou Héctor de Diego Paolo Fusar-Poli Prevalence of Individuals at Clinical High-Risk of Psychosis in the General Population and Clinical Samples: Systematic Review and Meta-Analysis
description	(1) The consistency and magnitude of the prevalence of Clinical High-Risk for Psychosis (CHR-P) individuals are undetermined, limiting efficient detection of cases. We aimed to evaluate the prevalence of CHR-P individuals systematically assessed in the general population or clinical samples. (2) PRISMA/MOOSE-compliant (PROSPERO: CRD42020168672) meta-analysis of multiple databases until 21/01/21: a random-effects model meta-analysis, heterogeneity analysis, publication bias and quality assessment, sensitivity analysis—according to the gold-standard CHR-P and pre-screening instruments—leave-one-study-out analyses, and meta-regressions were conducted. (3) 35 studies were included, with 37,135 individuals tested and 1554 CHR-P individuals identified (median age = 19.3 years, Interquartile range (IQR) = 15.8–22.1; 52.2% females, IQR = 38.7–64.4). In the general population (k = 13, <i>n</i> = 26,835 individuals evaluated), the prevalence of the CHR-P state was 1.7% (95% Confidence Interval (CI) = 1.0–2.9%). In clinical samples (k = 22, <i>n</i> = 10,300 individuals evaluated), the prevalence of the CHR-P state was 19.2% (95% CI = 12.9–27.7%). Using a pre-screening instrument was associated with false negatives (5.6%, 95% CI = 2.2–13.3%) and a lower CHR-P prevalence (11.5%, 95% CI = 6.2–20.5%) compared to using CHR-P instruments only (28.5%, 95% CI = 23.0–34.7%, <i>p</i> = 0.003). (4) The prevalence of the CHR-P state is low in the general population and ten times higher in clinical samples. The prevalence of CHR-P may increase with a higher proportion of females in the general population and with a younger population in clinical samples. The CHR-P state may be unrecognized in routine clinical practice. These findings can refine detection and preventive strategies.
format	article
author	Gonzalo Salazar de Pablo Scott W. Woods Georgia Drymonitou Héctor de Diego Paolo Fusar-Poli
author_facet	Gonzalo Salazar de Pablo Scott W. Woods Georgia Drymonitou Héctor de Diego Paolo Fusar-Poli
author_sort	Gonzalo Salazar de Pablo
title	Prevalence of Individuals at Clinical High-Risk of Psychosis in the General Population and Clinical Samples: Systematic Review and Meta-Analysis
title_short	Prevalence of Individuals at Clinical High-Risk of Psychosis in the General Population and Clinical Samples: Systematic Review and Meta-Analysis
title_full	Prevalence of Individuals at Clinical High-Risk of Psychosis in the General Population and Clinical Samples: Systematic Review and Meta-Analysis
title_fullStr	Prevalence of Individuals at Clinical High-Risk of Psychosis in the General Population and Clinical Samples: Systematic Review and Meta-Analysis
title_full_unstemmed	Prevalence of Individuals at Clinical High-Risk of Psychosis in the General Population and Clinical Samples: Systematic Review and Meta-Analysis
title_sort	prevalence of individuals at clinical high-risk of psychosis in the general population and clinical samples: systematic review and meta-analysis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/545c59ffca9b412e8017658a9dd8fc63
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Prevalence of Individuals at Clinical High-Risk of Psychosis in the General Population and Clinical Samples: Systematic Review and Meta-Analysis

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