Physical Health and Transition to Psychosis in People at Clinical High Risk
Background: The clinical high risk for psychosis (CHR-P) construct represents an opportunity for prevention and early intervention in young adults, but the relationship between risk for psychosis and physical health in these patients remains unclear. Methods: We conducted a RECORD-compliant clinical...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-02-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/12/3/523 |
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| author | Andrea De Micheli Umberto Provenzani Kamil Krakowski Dominic Oliver Stefano Damiani Natascia Brondino Philip McGuire Paolo Fusar-Poli |
| author_facet | Andrea De Micheli Umberto Provenzani Kamil Krakowski Dominic Oliver Stefano Damiani Natascia Brondino Philip McGuire Paolo Fusar-Poli |
| author_sort | Andrea De Micheli |
| collection | DOAJ |
| description | Background: The clinical high risk for psychosis (CHR-P) construct represents an opportunity for prevention and early intervention in young adults, but the relationship between risk for psychosis and physical health in these patients remains unclear. Methods: We conducted a RECORD-compliant clinical register-based cohort study, selecting the long-term cumulative risk of developing a persistent psychotic disorder as the primary outcome. We investigated associations between primary outcome and physical health data with Electronic Health Records at the South London and Maudsley (SLaM) NHS Trust, UK (January 2013–October 2020). We performed survival analyses using Kaplan-Meier curves, log-rank tests, and Cox proportional hazard models. Results: The database included 137 CHR-P subjects; 21 CHR-P developed psychosis during follow-up, and the cumulative incidence of psychosis risk was 4.9% at 1 year and 56.3% at 7 years. Log-rank tests suggested that psychosis risk might change between different levels of nicotine and alcohol dependence. Kaplan-Meier curve analyses indicated that non-hazardous drinkers may have a lower psychosis risk than non-drinkers. In the Cox proportional hazard model, nicotine dependence presented a hazard ratio of 1.34 (95% CI: 1.1–1.64) (<i>p</i> = 0.01), indicating a 34% increase in psychosis risk for every additional point on the Fagerström Test for Nicotine Dependence. Conclusions: Our findings suggest that a comprehensive assessment of tobacco and alcohol use, diet, and physical activity in CHR-P subjects is key to understanding how physical health contributes to psychosis risk. |
| first_indexed | 2024-04-24T18:32:09Z |
| format | Article |
| id | doaj.art-42d55cfc77aa43ea9c312d1aae5dfa86 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-04-24T18:32:09Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-42d55cfc77aa43ea9c312d1aae5dfa862024-03-27T13:22:39ZengMDPI AGBiomedicines2227-90592024-02-0112352310.3390/biomedicines12030523Physical Health and Transition to Psychosis in People at Clinical High RiskAndrea De Micheli0Umberto Provenzani1Kamil Krakowski2Dominic Oliver3Stefano Damiani4Natascia Brondino5Philip McGuire6Paolo Fusar-Poli7Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AB, UKDepartment of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, ItalyEarly Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AB, UKEarly Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AB, UKDepartment of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, ItalyDepartment of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, ItalyDepartment of Psychiatry, University of Oxford, Oxford OX3 7JX, UKEarly Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AB, UKBackground: The clinical high risk for psychosis (CHR-P) construct represents an opportunity for prevention and early intervention in young adults, but the relationship between risk for psychosis and physical health in these patients remains unclear. Methods: We conducted a RECORD-compliant clinical register-based cohort study, selecting the long-term cumulative risk of developing a persistent psychotic disorder as the primary outcome. We investigated associations between primary outcome and physical health data with Electronic Health Records at the South London and Maudsley (SLaM) NHS Trust, UK (January 2013–October 2020). We performed survival analyses using Kaplan-Meier curves, log-rank tests, and Cox proportional hazard models. Results: The database included 137 CHR-P subjects; 21 CHR-P developed psychosis during follow-up, and the cumulative incidence of psychosis risk was 4.9% at 1 year and 56.3% at 7 years. Log-rank tests suggested that psychosis risk might change between different levels of nicotine and alcohol dependence. Kaplan-Meier curve analyses indicated that non-hazardous drinkers may have a lower psychosis risk than non-drinkers. In the Cox proportional hazard model, nicotine dependence presented a hazard ratio of 1.34 (95% CI: 1.1–1.64) (<i>p</i> = 0.01), indicating a 34% increase in psychosis risk for every additional point on the Fagerström Test for Nicotine Dependence. Conclusions: Our findings suggest that a comprehensive assessment of tobacco and alcohol use, diet, and physical activity in CHR-P subjects is key to understanding how physical health contributes to psychosis risk.https://www.mdpi.com/2227-9059/12/3/523physical healthpsychosisriskCHR-P |
| spellingShingle | Andrea De Micheli Umberto Provenzani Kamil Krakowski Dominic Oliver Stefano Damiani Natascia Brondino Philip McGuire Paolo Fusar-Poli Physical Health and Transition to Psychosis in People at Clinical High Risk Biomedicines physical health psychosis risk CHR-P |
| title | Physical Health and Transition to Psychosis in People at Clinical High Risk |
| title_full | Physical Health and Transition to Psychosis in People at Clinical High Risk |
| title_fullStr | Physical Health and Transition to Psychosis in People at Clinical High Risk |
| title_full_unstemmed | Physical Health and Transition to Psychosis in People at Clinical High Risk |
| title_short | Physical Health and Transition to Psychosis in People at Clinical High Risk |
| title_sort | physical health and transition to psychosis in people at clinical high risk |
| topic | physical health psychosis risk CHR-P |
| url | https://www.mdpi.com/2227-9059/12/3/523 |
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