Implementing Learning Health System Principles to Advance the Evaluation and Treatment of Clinical High-Risk for Psychosis.

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Tác giả: Corinne Cather, Jacqueline A Clauss, Abigail L Donovan, Cheryl Y S Foo, Daphne J Holt, Lauren Utter

Ngôn ngữ: eng

Ký hiệu phân loại: 809.008 History and description with respect to kinds of persons

Thông tin xuất bản: United States : medRxiv : the preprint server for health sciences , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 748400

BACKGROUND: Early intervention for individuals with clinical high-risk for psychosis (CHR-P) aims to prevent the onset of serious mental illnesses like schizophrenia, but models for specialized care remain underdeveloped. We describe the development, feasibility, and value of a CHR-P evaluation and treatment program built on learning health system principles. We demonstrate that referral and intake clinical assessment data can improve the characterization and identification of individuals with CHR-P. METHODS: The Resilience Evaluation-Social Emotional Training (RE-SET) Program, developed as part of a continuum of psychosis care programs at Massachusetts General Hospital, systematically collects clinical data at referral, intake evaluation, and during treatment. In this study, at referral, providers, caregivers, and/or patients reported on the patient's psychiatric history. Patients for whom there were concerns for attenuated psychosis were eligible for evaluation. Prior to diagnostic evaluation, patients completed self-report measures of a broad range of psychiatric symptoms. Patients were evaluated with the Structured Interview for Psychosis-Risk Syndromes (SIPS) to determine if they met CHR-P criteria. Using referral and intake data from 118 help-seeking individuals, we performed univariate chi-square or independent samples t-test to identify factors associated with CHR-P syndrome. RESULTS: Ninety-nine CONCLUSIONS: Identification of CHR-P may be improved with greater attention to developmental history, psychotic symptoms, sleep disturbance, and cognitive and behavioral difficulties. Integrating routine assessment into clinical care provides data-driven opportunities to improve the identification and treatment of CHR-P.
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