Advancements and Future Directions in Prevention Based on Evaluation for Individuals With Clinical High Risk of Psychosis: Insights From the SHARP Study

TianHong Zhang; LiHua Xu; YanYan Wei; HuiRu Cui; XiaoChen Tang; YeGang Hu; YingYing Tang; ZiXuan Wang; HaiChun Liu; Tao Chen; ChunBo Li; JiJun Wang

doi:10.1093/schbul/sbae066

Advancements and Future Directions in Prevention Based on Evaluation for Individuals With Clinical High Risk of Psychosis: Insights From the SHARP Study

Schizophr Bull. 2024 May 14:sbae066. doi: 10.1093/schbul/sbae066. Online ahead of print.

Authors

TianHong Zhang¹, LiHua Xu¹, YanYan Wei¹, HuiRu Cui¹, XiaoChen Tang¹, YeGang Hu¹, YingYing Tang¹, ZiXuan Wang², HaiChun Liu³, Tao Chen^{4

5}, ChunBo Li¹, JiJun Wang^{1

6

7}

Affiliations

¹ Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, PR China.
² Department of Psychology, Shanghai Xinlianxin Psychological Counseling Center, Shanghai, China.
³ Department of Automation, Shanghai Jiao Tong University, Shanghai, China.
⁴ Big Data Research Lab, University of Waterloo, Ontario, Canada.
⁵ Labor and Worklife Program, Harvard University, Cambridge, MA, USA.
⁶ Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, PR China.
⁷ Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, PR China.

PMID: 38741342
DOI: 10.1093/schbul/sbae066

Abstract

Background and hypothesis: This review examines the evolution and future prospects of prevention based on evaluation (PBE) for individuals at clinical high risk (CHR) of psychosis, drawing insights from the SHARP (Shanghai At Risk for Psychosis) study. It aims to assess the effectiveness of non-pharmacological interventions in preventing psychosis onset among CHR individuals.

Study design: The review provides an overview of the developmental history of the SHARP study and its contributions to understanding the needs of CHR individuals. It explores the limitations of traditional antipsychotic approaches and introduces PBE as a promising framework for intervention.

Study results: Three key interventions implemented by the SHARP team are discussed: nutritional supplementation based on niacin skin response blunting, precision transcranial magnetic stimulation targeting cognitive and brain functional abnormalities, and cognitive behavioral therapy for psychotic symptoms addressing symptomatology and impaired insight characteristics. Each intervention is evaluated within the context of PBE, emphasizing the potential for tailored approaches to CHR individuals.

Conclusions: The review highlights the strengths and clinical applications of the discussed interventions, underscoring their potential to revolutionize preventive care for CHR individuals. It also provides insights into future directions for PBE in CHR populations, including efforts to expand evaluation techniques and enhance precision in interventions.

Keywords: biomarker; intervention; prodrome; transition; ultra high risk.

© The Author(s) 2024. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

Abstract

Grants and funding