ITAlian partnership for psychosis prevention (ITAPP): Improving the mental health of young people.

Abstract

The European impact of the clinical high risk for psychosis (CHR-P) paradigm is constrained by the lack of critical mass (detection) to power prognostic and preventive interventions. An ITAlian partnership for psychosis prevention (ITAPP) was created across CHR-P centers, which were surveyed to describe: (a) service, catchment area, and outreach; (b) service users; and (c) interventions and outcomes. Descriptive statistics and Kaplan-Meier failure function complemented the analyses. The ITAPP included five CHR-P clinical academic centers established from 2007 to 2018, serving about 13million inhabitants, with a recruitment capacity of 277 CHR-P individuals (mean age: 18.7years, SD: 4.8, range: 12-39years; 53.1% females; 85.7% meeting attenuated psychotic symptoms; 85.8% without any substance abuse). All centers were multidisciplinary and included adolescents and young adults (transitional) primarily recruited through healthcare services. The comprehensive assessment of at-risk mental state was the most widely used instrument, while the duration of follow-up, type of outreach, and preventive interventions were heterogeneous. Across 205 CHR-P individuals with follow up (663.7days±551.7), the cumulative risk of psychosis increased from 8.7% (95% CI 5.3-14.1) at 1year to 15.9% (95% CI 10.6-23.3) at 2years, 21.8% (95% CI 14.9-31.3) at 3years, 34.8% (95% CI 24.5-47.9) at 4years, and 51.9% (95% CI 36.3-69.6) at 5years. The ITAPP is one of the few CHR-P clinical research partnerships in Europe for fostering detection, prognosis, and preventive care, as well as for translating research innovations into practice.