A systematic review of treatments for attenuated psychotic symptoms

Abstract EN

Objective : clinical high-risk for psychosis (CHR-p) describes the pre-psychotic phase in which individuals present prodromal symptoms.

the primary objective of most studies has been to decrease the transition rate to psychosis and measuring attenuated psychotic symptoms(aps) is usually the secondary objective.

therefore, the present systematic review aimed to evaluate the success of available treatments in improving the aps in individuals at CHR-p.

methods : prisma guidelines were followed for this systematic review.

the electronic search process was conducted in PubMed, google scholar, and Cochrane.

the search strategy involved comprehensive search terms using the appropriate subject heading and Boolean operators.

studies published till April 2020 reporting on aps were included in the review.

results : overall, 3258 patients from 46 studies were included.

cognitive remediation, antipsychotics, family-based therapy, cognitive behavioral therapy(CBT), omega-3 supplementation, n-methyl-daspartate receptor modulators, and mood stabilizers were found inconclusive in providing significant and consistent improvement in aps.

CBT was found to give mixed results in reducing aps compared with supported therapy or treatment as usual at 6-18 month follow up, and only 2 studies reported a significant reduction in symptoms as compared with the control group.

conclusions: no robust evidence was found supporting any specific intervention for the treatment of aps in CHR-p individuals.

duration of intervention, alliance with the therapist, as well as the presence of drug-naïve population were key factors in determining the outcome of the intervention.