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. 2024 Sep;18(9):739-749.
doi: 10.1111/eip.13514. Epub 2024 Feb 13.

Identification of distinct clinical profiles and trajectories in individuals at high risk of developing psychosis: A latent profile analysis of the north American prodrome longitudinal study consortium-3 dataset

Daniel Bergé  1 , Cameron S Carter  2 , Jason Smucny  2
Affiliations

Identification of distinct clinical profiles and trajectories in individuals at high risk of developing psychosis: A latent profile analysis of the north American prodrome longitudinal study consortium-3 dataset

Daniel Bergé et al. Early Interv Psychiatry. 2024 Sep.

Abstract

Aim: People at clinical high risk (CHR) for psychosis are a heterogeneous population in regard to clinical presentation and outcome. It is unclear, however, if their baseline clinical characteristics can be used to construct orthogonal subgroups that differ in their clinical trajectory to provide early identification of individuals in need of tailored interventions.

Methods: We used latent profile analysis (LPA) to determine the number of distinct clinical profiles within the CHR population using the NAPLS-3 dataset, focusing on the clinical features incorporated in the NAPLS psychosis risk calculator (including age, unusual thought content and suspiciousness, processing speed, verbal learning and memory function, social functioning decline, life events, childhood trauma, and family history of psychosis). We then conducted a between-profile comparisons of clinical trajectories based on psychotic and depressive symptoms as well as substance use disorder (SUD) related features over time.

Results: Two distinct profiles emerged. One profile, comprising approximately 25% of the sample, was significantly older, displayed better cognitive performance, experienced more types of traumatic and undesirable life events, exhibited a greater decline in functioning in the past year, and was more likely to have relatives with psychosis. This group showed worse positive symptoms and SUD-related features over time, although groups did not differ in the proportion of individuals who developed psychosis.

Conclusions: LPA results suggest CHRs can be segregated into two profiles with different clinical trajectories. Characterizing individuals within these clinical profiles may help understand the divergent outcomes of this population and ultimately facilitate the development of specialized interventions.

Keywords: at risk mental state; clinical high risk; prodromal phase; psychosis; schizophrenia.

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Conflict of interest statement

Conflict of interest disclosure: The authors declare no conflicts of interest.

Figures

Figure 1.
Figure 1.
Longitudinal trajectories of clinical outcome measures for each clinical high risk Profile as well as healthy control (HC) individuals. Abbreviations: GAF = Global Assessment of Function, SOPS = Scale of Prodromal Symptoms.
Figure 2.
Figure 2.
Longitudinal trajectories of alcohol, cannabis, and tobacco substance use disorder outcome measures for each clinical high risk profile as well as healthy control (HC) individuals. "Fraction of responses" refers to the proportion of individuals within a group (HC, Profile 1, Profile 2) that presented with a particular dependence level/frequency of use.
See this image and copyright information in PMC

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