Interventions and Transition in Youth at Risk of Psychosis: A Systematic Review and Meta-Analyses
Abstract
Objective The primary objective of this systematic review and meta-analyses was to summarize the impact of all reported treatments on transition to psychosis in high-risk samples. Data sources PsycINFO, Embase, CINAHL, EBM, and MEDLINE online databases were searched from inception to May 2017 using the keywords psychosis, risk, and treatment with no geographical, date, or language restrictions. Study selection A total of 38 independent studies met the inclusion criteria: conducted a treatment study in a sample at high risk for psychosis and reported on transition to psychosis as an outcome. Data extraction The following data were extracted: study characteristics (eg, sample size), participant characteristics (eg, mean age), and clinical outcome data (eg, number and percentage of patients transited for each intervention group at each time-point and transition assessment employed). Data were analyzed using random-effects pairwise meta-analysis (to explore differences between treatment and controls) and multivariate network meta-analyses (NMAs; to explore differences between treatment types on transition) and were reported as risk ratios (RR). Results In pairwise meta-analyses, cognitive-behavioral therapy (CBT) studies were associated with a significant reduction in transition compared with controls at 12-month and 18-month follow-up (RR = 0.57; 95% CI, 0.35-0.93; I² = 7%; P = .02 vs RR = 0.54; 95% CI, 0.32-0.92; I² = 0%; P = .02). In the NMAs, integrated psychological therapy,…
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Network meta-analyses suggest a paucity of evidence for the superiority of any one type of intervention for indicated prevention of psychosis.
“Although network meta-analyses suggest a paucity of evidence for the superiority of any one type of intervention, 279,281 the included trials indicate that transition rates are reduced at a group level. 282”
From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [279]
Pairwise meta-analyses support the efficacy of cognitive behavioural interventions in reducing the likelihood of transition to psychosis in individuals at ultra-high risk for psychosis.
“Regarding indicated prevention of psychosis, pairwise meta-analyses support the efficacy of cognitive behavioural interventions in reducing the likelihood of transition to psychosis in individuals at ultra-high risk for psychosis. 279,280”
From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [279]
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The Lancet Psychiatry Commission on youth mental health
McGorry, P. D., Mei, C., Dalal, N., Alvarez-Jimenez, M., Blakemore, S.-J., Browne, V., Dooley, B., Hickie, I. B., Jones, P. B., McDaid, D., et al. (2024) · The Lancet Psychiatry · doi:10.1016/s2215-0366(24)00163-9 · Cited by 663 · see citing works
Preventive psychiatry: a blueprint for improving the mental health of young people
Fusar‐Poli, P., Correll, C. U., Arango, C., Berk, M., Patel, V., & Ioannidis, J. P. A. (2021) · World Psychiatry · doi:10.1002/wps.20869 · Cited by 497 · see citing works
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McGorry, P. D., Mei, C., Amminger, G. P., Yuen, H. P., Kerr, M., Spark, J., Wallis, N., Polari, A., Baird, S., Buccilli, K., et al. (2023) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2023.1947 · Cited by 48 · see citing works
Fusar‐Poli, P., Radua, J., & Jauhar, S. (2021) · World Psychiatry · doi:10.1002/wps.20896 · Cited by 12 · see citing works
- Authors
- Devoe, D. J., Farris, M. S., Townes, P., & Addington, J.
- Affiliations
- University of Calgary (CA)
- Corresponding author
- Addington, Jean
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2020-05-19
- Volume
- 81
- Issue
- 3
- ISSN
- 0160-6689 (ISSN-L)
- 1555-2101
- OpenAlex
- W3028098818
- Cited by
- 49
- References
- 0
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 11 · 2023: 8 · 2022: 9 · 2021: 12 · 2020: 1
- FWCI
- 5.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (R01MH105178)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- psychosis risk, transition to psychosis, youth, cognitive behavioral therapy, psychological intervention, family therapy, omega-3 fatty acids, antipsychotic augmentation, integrated psychological therapy, supportive therapy, needs-based intervention
- MeSH terms
- Adolescent, Adult, Child, Humans, Psychotherapy, Psychotic Disorders, Risk Factors, Antipsychotic Agents, Disease Progression, Young Adult
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