A Study of Antipsychotics in Individuals at Clinical High-risk for Psychosis (the SHARP-2 Study)

NCT04010864 | Unknown

• 1 other identifier: CRC2018ZD04
• Study Type: observational
• Target: 600
• Locations: 1 country
• Sites: 1

Brief Summary

The current study will improve knowledge on the effectiveness and safety of the use of antipsychotics at the prodromal phase and on factors influencing the outcome, and will eventually facilitate optimisation of individualised interventions for psychosis prevention and treatment.

Conditions

Clinical High-risk

Outcome Measures

Primary Outcomes (2)

• Conversion to psychosis

  It will be determined using the criteria for the Presence of Psychotic Symptoms from SIPS. Specifically, the conversion will be defined by the presence of level 6 positive symptoms (the rating "6" refers to severe and psychotic symptoms) identified as either dangerous, disorganised, or occurring at least one hour a day on average, over four days a week for at least 16 hours.

  4 weeks

• Poor function

  It will be determined by GAF score. Specifically, poor function outcome is defined as the GAF score of less than 60 at the follow-up point.

  4 weeks

Study Arms (1)

SHARP-2

ShangHai At Risk for Psychosis-Phase 2

Other: routine clinical treatment

Interventions

routine clinical treatment OTHER

Participants will be informed that this is not a treatment study and it involves naturalistic follow-up without any extra intervention. They will otherwise follow the routine clinical treatment procedure.

SHARP-2

Eligibility Criteria

• Age: 14 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Help-seeking first-visit participants will be consecutively recruited from the Shanghai Psychotherapy and Psychological Counselling Centre at the Shanghai Mental Health Centre. They will be screened for eligibility by their clinicians.

You may qualify if:

• be aged 14 to 45-year-old
• have had at least 6-years of primary education
• be drug-naïve
• be understanding the survey, be willing to enrol in the study and sign the informed consent
• Through the Structured Interview for Prodromal Syndromes/Scale of Prodromal Symptoms (SIPS/SOPS), the participants should meet the Criteria of Prodromal Syndrome. Participants should fulfil at least one of the prodromal syndrome criteria: (1) brief intermittent psychotic syndrome, (2) attenuated positive symptom syndrome, or (3) genetic risk and deterioration syndrome

You may not qualify if:

• Through the Mini-International Neuropsychiatric Interview (MINI), Axis I mental disorders such as schizophrenia, affective disorders, and anxiety spectrum disorders will be excluded
• Acute or chronic renal failure; liver cirrhosis or active liver diseases
• Abnormal laboratory tests results judged by the researchers to be clinically significant and considered to affect the efficacy of the test drugs or the safety of the subjects
• Severe or unstable physical diseases, including: neurological disorders (delirium, dementia, stroke, epilepsy, migraine, etc.), congestive heart failure, angina pectoris, myocardial infarction, arrhythmia, hypertension (including untreated or uncontrolled hypertension), malignant tumours, immune compromise, and blood glucose above 12 mmol/L
• Alcohol abuse within 30 days, or alcohol or drug dependence within 6 months before the trial
• Pregnant or lactating women, or women in childbearing age who are positive in urine human chorionic gonadotropin test, or men and women who do not take effective contraceptive measures or plan for pregnancy within 3 months after the initiation of the trial
• Stroke within the last month
• Participating in any clinical trial within 30 days before the baseline
• Other situations judged by the investigators not to be suitable for the clinical trial

Sponsors & Collaborators

• Shanghai Mental Health Center: lead
• Ministry of Science and Technology of the People´s Republic of China: collaborator
• National Natural Science Foundation of China: collaborator
• Shanghai Municipal Science and Technology Commission: collaborator
• Shanghai Jiao Tong University School of Medicine: collaborator

Study Sites (1)

Shanghai Mental Health Center

Shanghai, China

RECRUITING

Related Publications (15)

• Fusar-Poli P, Borgwardt S, Bechdolf A, Addington J, Riecher-Rossler A, Schultze-Lutter F, Keshavan M, Wood S, Ruhrmann S, Seidman LJ, Valmaggia L, Cannon T, Velthorst E, De Haan L, Cornblatt B, Bonoldi I, Birchwood M, McGlashan T, Carpenter W, McGorry P, Klosterkotter J, McGuire P, Yung A. The psychosis high-risk state: a comprehensive state-of-the-art review. JAMA Psychiatry. 2013 Jan;70(1):107-20. doi: 10.1001/jamapsychiatry.2013.269.

  PMID: 23165428 BACKGROUND

• Nelson B, Yuen HP, Wood SJ, Lin A, Spiliotacopoulos D, Bruxner A, Broussard C, Simmons M, Foley DL, Brewer WJ, Francey SM, Amminger GP, Thompson A, McGorry PD, Yung AR. Long-term follow-up of a group at ultra high risk ("prodromal") for psychosis: the PACE 400 study. JAMA Psychiatry. 2013 Aug;70(8):793-802. doi: 10.1001/jamapsychiatry.2013.1270.

  PMID: 23739772 BACKGROUND

• Lindstrom E, Bingefors K. Patient compliance with drug therapy in schizophrenia. Economic and clinical issues. Pharmacoeconomics. 2000 Aug;18(2):106-24. doi: 10.2165/00019053-200018020-00002.

  PMID: 11067646 BACKGROUND

• Crumlish N, Whitty P, Clarke M, Browne S, Kamali M, Gervin M, McTigue O, Kinsella A, Waddington JL, Larkin C, O'Callaghan E. Beyond the critical period: longitudinal study of 8-year outcome in first-episode non-affective psychosis. Br J Psychiatry. 2009 Jan;194(1):18-24. doi: 10.1192/bjp.bp.107.048942.

  PMID: 19118320 BACKGROUND

• Zhang T, Xu L, Tang Y, Cui H, Wei Y, Wang J, Tang X, Li C, Wang J. Duration of untreated prodromal symptoms in a Chinese sample at a high risk for psychosis: demographic, clinical, and outcome. Psychol Med. 2018 Jun;48(8):1274-1281. doi: 10.1017/S0033291717002707. Epub 2017 Nov 27.

  PMID: 29173206 BACKGROUND

• Zhang T, Xu L, Tang Y, Cui H, Tang X, Wei Y, Wang Y, Hu Q, Qian Z, Liu X, Li C, Wang J. Relationship between duration of untreated prodromal symptoms and symptomatic and functional recovery. Eur Arch Psychiatry Clin Neurosci. 2019 Dec;269(8):871-877. doi: 10.1007/s00406-018-0917-z. Epub 2018 Jun 25.

  PMID: 29942980 BACKGROUND

• Zhang T, Cui H, Wei Y, Tang Y, Xu L, Tang X, Zhu Y, Jiang L, Zhang B, Qian Z, Chow A, Liu X, Li C, Xiao Z, Wang J. Progressive decline of cognition during the conversion from prodrome to psychosis with a characteristic pattern of the theory of mind compensated by neurocognition. Schizophr Res. 2018 May;195:554-559. doi: 10.1016/j.schres.2017.08.020. Epub 2017 Aug 18.

  PMID: 28823722 BACKGROUND

• Zhang T, Cui H, Tang Y, Xu L, Li H, Wei Y, Liu X, Chow A, Li C, Jiang K, Xiao Z, Wang J. Correlation of social cognition and neurocognition on psychotic outcome: a naturalistic follow-up study of subjects with attenuated psychosis syndrome. Sci Rep. 2016 Oct 10;6:35017. doi: 10.1038/srep35017.

  PMID: 27721394 BACKGROUND

• Collin G, Seidman LJ, Keshavan MS, Stone WS, Qi Z, Zhang T, Tang Y, Li H, Anteraper SA, Niznikiewicz MA, McCarley RW, Shenton ME, Wang J, Whitfield-Gabrieli S. Functional connectome organization predicts conversion to psychosis in clinical high-risk youth from the SHARP program. Mol Psychiatry. 2020 Oct;25(10):2431-2440. doi: 10.1038/s41380-018-0288-x. Epub 2018 Nov 8.

  PMID: 30410064 BACKGROUND

• Shakory S, Watts JJ, Hafizi S, Da Silva T, Khan S, Kiang M, Bagby RM, Chavez S, Mizrahi R. Hippocampal glutamate metabolites and glial activation in clinical high risk and first episode psychosis. Neuropsychopharmacology. 2018 Oct;43(11):2249-2255. doi: 10.1038/s41386-018-0163-0. Epub 2018 Jul 28.

  PMID: 30087434 BACKGROUND

• Rauchensteiner S, Kawohl W, Ozgurdal S, Littmann E, Gudlowski Y, Witthaus H, Heinz A, Juckel G. Test-performance after cognitive training in persons at risk mental state of schizophrenia and patients with schizophrenia. Psychiatry Res. 2011 Feb 28;185(3):334-9. doi: 10.1016/j.psychres.2009.09.003. Epub 2010 May 21.

  PMID: 20493540 BACKGROUND

• Amminger GP, Schafer MR, Papageorgiou K, Klier CM, Cotton SM, Harrigan SM, Mackinnon A, McGorry PD, Berger GE. Long-chain omega-3 fatty acids for indicated prevention of psychotic disorders: a randomized, placebo-controlled trial. Arch Gen Psychiatry. 2010 Feb;67(2):146-54. doi: 10.1001/archgenpsychiatry.2009.192.

  PMID: 20124114 BACKGROUND

• McGorry PD, Nelson B, Markulev C, Yuen HP, Schafer MR, Mossaheb N, Schlogelhofer M, Smesny S, Hickie IB, Berger GE, Chen EY, de Haan L, Nieman DH, Nordentoft M, Riecher-Rossler A, Verma S, Thompson A, Yung AR, Amminger GP. Effect of omega-3 Polyunsaturated Fatty Acids in Young People at Ultrahigh Risk for Psychotic Disorders: The NEURAPRO Randomized Clinical Trial. JAMA Psychiatry. 2017 Jan 1;74(1):19-27. doi: 10.1001/jamapsychiatry.2016.2902.

  PMID: 27893018 BACKGROUND

• McGorry PD, Yung AR, Phillips LJ, Yuen HP, Francey S, Cosgrave EM, Germano D, Bravin J, McDonald T, Blair A, Adlard S, Jackson H. Randomized controlled trial of interventions designed to reduce the risk of progression to first-episode psychosis in a clinical sample with subthreshold symptoms. Arch Gen Psychiatry. 2002 Oct;59(10):921-8. doi: 10.1001/archpsyc.59.10.921.

  PMID: 12365879 BACKGROUND

• Zeng J, Raballo A, Gan R, Wu G, Wei Y, Xu L, Tang X, Hu Y, Tang Y, Chen T, Li C, Wang J, Zhang T. Antipsychotic Exposure in Clinical High Risk of Psychosis: Empirical Insights From a Large Cohort Study. J Clin Psychiatry. 2022 Mar 21;83(3):21m14092. doi: 10.4088/JCP.21m14092.

  PMID: 35324095 DERIVED

Biospecimen

Retention: SAMPLES WITH DNA

whole blood

Study Officials

• TianHong Zhang, Doctor

  Shanghai Mental Health Center

  PRINCIPAL INVESTIGATOR

Central Study Contacts

TianHong Zhang, Doctor

CONTACT

13127577024; zhang_tianhong@126.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 3 Years
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: associate research fellow

Study Record Dates

• First Submitted: July 4, 2019
• First Posted: July 8, 2019
• Study Start: March 29, 2019
• Primary Completion: December 1, 2022
• Study Completion: December 1, 2022
• Last Updated: October 22, 2020

Record last verified: 2020-10

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE

Locations

CN (1)