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Negative symptoms in children and adolescents with early-onset psychosis and at clinical high-risk for psychosis: systematic review and meta-analysis

 Gonzalo Salazar de Pablo  ;  Ana Catalan  ;  Julio Vaquerizo Serrano  ;  Borja Pedruzo  ;  Luis Alameda  ;  Veronica Sandroni  ;  Alvaro Armendariz  ;  Victoria Rodriguez  ;  Celso Arango  ;  Carmen Moreno  ;  Johnny Downs  ;  Chris Abbott  ;  Jae Il Shin  ;  Marco Solmi  ;  Paolo Fusar-Poli  ;  Christoph U Correll 
 BRITISH JOURNAL OF PSYCHIATRY, Vol.223(1) : 282-294, 2023-07 
Journal Title
Issue Date
Child ; Humans ; Male ; Prognosis ; Psychotic Disorders* / diagnosis ; Psychotic Disorders* / epidemiology ; Psychotic Disorders* / therapy
Early-onset psychosis ; clinical high risk of psychosis ; meta-analysis ; prevention ; psychotic disorders
Background Early-onset psychosis (EOP) refers to the development of a first episode of psychosis before 18 years of age. Individuals at clinical high risk for psychosis (CHR-P) include adolescents and young adults, although most evidence has focused on adults. Negative symptoms are important prognostic indicators in psychosis. However, research focusing on children and adolescents is limited. Aims To provide meta-analytical evidence and a comprehensive review of the status and advances in the diagnosis, prognosis and treatment of negative symptoms in children and adolescents with EOP and at CHR-P. Method PRISMA/MOOSE-compliant systematic review (PROSPERO: CRD42022360925) from inception to 18 August 2022, in any language, to identify individual studies conducted in EOP/CHR-P children and adolescents (mean age <18 years) providing findings on negative symptoms. Findings were systematically appraised. Random-effects meta-analyses were performed on the prevalence of negative symptoms, carrying out sensitivity analyses, heterogeneity analyses, publication bias assessment and quality assessment using the Newcastle-Ottawa Scale. Results Of 3289 articles, 133 were included (n = 6776 EOP, mean age 15.3 years (s.d. = 1.6), males = 56.1%; n = 2138 CHR-P, mean age 16.1 years (s.d. = 1.0), males = 48.6%). There were negative symptoms in 60.8% (95% CI 46.4%-75.2%) of the children and adolescents with EOP and 79.6% (95% CI 66.3-92.9%) of those at CHR-P. Prevalence and severity of negative symptoms were associated with poor clinical, functional and intervention outcomes in both groups. Different interventions were piloted, with variable results requiring further replication. Conclusions Negative symptoms are common in children and adolescents at early stages of psychosis, particularly in those at CHR-P, and are associated with poor outcomes. Future intervention research is required so that evidence-based treatments will become available. Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Shin, Jae Il(신재일) ORCID logo https://orcid.org/0000-0003-2326-1820
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