Symptom Profiles Related to Psychotropic Medications in youth at Clinical High-Risk for Psychosis Restricted; Files Only
Zhou, Qing (Dolores) (Spring 2025)
Abstract
Background:
For individuals at clinical high risk for psychosis (CHR-P), research suggests that baseline antipsychotic use is linked with higher psychosis conversion, but this may be due to confounding symptom severity with medication. This study examines associations between post-baseline psychotropic medication by CHR-P youth and changes in symptoms at 4-month follow-up.
Methods:
Utilizing data from the North American Prodrome Longitudinal Study 3 (NAPLS-3), we examined symptom severity reduction between baseline and 4-month follow-up among CHR-P youth not on baseline psychotropics. Positive, Negative, Disorganization, and General domains were evaluated using the Scale of Prodromal Symptoms (SOPS). We hypothesized that the initiation of antipsychotics post-baseline would be associated with reduced symptom severity at the follow-up compared to no psychotropic medication. Data analyses included nonparametric and propensity score matching methods to explore symptom trajectories across 3 medication types (antipsychotics, antidepressants, and antipsychotics with other psychotropics).
Results:
The sample included 138 participants in four groups: those receiving antipsychotic medication only (AP, n = 9), antipsychotic with other psychotropic medications (n = 8), antidepressant medication only (n = 17), and a group with no psychotropic medications (n = 104). In the non-parametric test, significant medication group differences were found in positive (χ²(3, 138) = 9.67, p = .022) and general (χ²(3, 138) = 9.3, p = .022) symptoms. Post-hoc tests showed that antidepressants group had less positive symptom reduction compared to the antipsychotic group (Z = 2.48, p = 0.039) and the antipsychotic with another psychotropic medication group (Z = 2.40, p = 0.041. The antipsychotics (Z = -2.23, p = 0.076) and antidepressants group (Z = -2.21, p = 0.068) exhibited a greater decrease in general symptoms compared to no-medication control group.
Conclusions:
New antipsychotic medication prescription was associated with reductions in symptom severity over time, with variations observed across different symptom domains, underscoring the potential benefits of tailored symptom-specific management strategies in psychiatric care.
Table of Contents
Number of Tables: 7
Number of Figures: 2
Word Count for Abstract: 311
Word Count for Main Text: 10260
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