Table 3. Meta-analysis of Randomized Controlled Treatment Trials in HR Individuals Including Transition Data Up to 1 Year.
| Source | HR Inclusion Criteria | Focused Treatment | Contrast Group | DI, mo | NNT at 1 y, Mean (95% CI) | Transition at 1 y (Focused vs Contrast) | Meta-analysis | |
|---|---|---|---|---|---|---|---|---|
|
| ||||||||
| RR (95% CI) | P Value | |||||||
| McGorry et al,7 2002a | CAARMS | Risperidone, 1-2 mg + CBT + NBI (n=31) | NBI (n = 28) | 6 | 4 (2.1-18.3) | 19.3 vs 35.7, NS | 0.541 (0.225-1.297) | .17 |
| Morrison et al,9 2004b | CAARMS based | CT (n=37) | Monitoring (n=23) | 6 | 5 (2.3-63.8) | 5.7 vs 21.7, NS | 0.263 (0.057-1.205) | .09 |
| McGlashan et al,6 2006 | SIPS | Olanzapine, 5-15 mg (n=31) | Placebo (n=29) | 12 | 5 (2.3-inf) | 16.1 vs 37.9, NS | 0.425 (0.168-1.075) | .07 |
| Ammingeretal,8 2010 | CAARMS | ω-3 PUFA, 1.2 g (n=41) | Placebo (n=40) | 3 | 5 (2.6-13.7) | 4.8 vs 27.5, Sig | 0.175 (0.041-0.746) | .02 |
| Yung et al,140 2011 | CAARMS | Risperidone, 0.5-2 mg + CT (n=43) | CT+placebo (n=44) | 6 | NA | 4.7 vs 9.1 vs 7.1, NS c | 0.516 (0.100-2.658) | .43 |
| ST+placebo (n=28) | NS | |||||||
| Addington et al,141 2011 | SIPS | CBT (n = 27) | ST (n = 24) | 6 | 8 (3.7-inf) | 0 vs 12.5, NS | 0.128 (0.007-2.350) | .17 |
| Bechdolf et al,57 2012 | EIPS | IPI (n=63) | SC (n = 65) | 12 | 8 (4.2-27.3) | 3 vs 16.9, Sig | 0.178 (0.039-0.799) | .02 |
| Overalld | 273 | 281 | 7.3 | 5.8 | 7.6 vs 23 | 0.335 (0.219-0.575) | <.001 | |
Abbreviations: CAARMS, Comprehensive Assessment of At-Risk Mental State; CBT, cognitive behavior therapy; CT, cognitive therapy; DI, duration of intervention; EIPS, early initial prodromal state (COPER or first-degree relatives with psychosis plus functional decline); HR, clinical high risk; inf, infinite; IPI, integrated psychological intervention (CT, social skills, psychoeducation for family, and cognitive remediation); NA, not assessed; NBI, needs-based intervention; NNT, number needed to treat; NS, nonsignificant differences between focused treatment and contrast group; PUFA, polyunsaturated fatty acid; RR, risk ratio; SC, supportive counseling; Sig, significant; SIPS, Structured Interview for Prodromal Symptoms; ST, supportive therapy.
See also Phillips et al.142
See also Morrison et al.143 Additional evidence suggests that preventing the start of cannabis use or stopping already started use may diminish the risk of a psychotic disorder.144
Six-month results.
Random effects models applied, Q=3.590, P=.732, I2=0.