A multidimensional network analysis in clinical high-risk for psychosis and help-seeking youth

Introduction: Children and adolescents at clinical-high risk for psychosis (CHR-P) represent a subsample of help-seeking individuals attending early intervention services. However, knowledge about differences between help-seeking and CHR-P youth is limited. This study aims to (a) to build two network architectures: the first including both CHR-P and non-CHR-P help-seeking youth and the second including only CHR-P youth, and (b) to explore differences between the two network structures. Methods: We recruited 146 CHR-P and 103 non-CHR-P help-seeking youth in a specialized Child and Adolescence Neuropsychiatric Unit. They were assessed with the Structured Interview for Psychosis-Risk Syndromes, Children Depression Inventory, Multidimensional Anxiety Scale for Children, Global Functioning: Social, Global Functioning: Role, and Wechsler Intelligence Scale for Children/Wechsler Adult Intelligence Scale. Network analysis was applied to both help-seeking and CHR-P patients. Central nodes, relevant edges, and correlation stability coefficients were examined. Results: In the first network structure, depressive symptoms displayed the greatest number of connections. In the second network, two isolated “archipelagos of symptoms” were observed: (a) a component including subclinical psychotic symptoms (positive symptoms excluded), functioning and comorbid symptoms, and (b) a sub-graph including only subclinical positive symptoms and IQ. Subclinical negative and disorganization symptoms were the most central nodes, and functioning played a key role in bridging subclinical psychotic and non-psychotic symptoms. The correlation stability coefficient of the second network was above .50. Discussion: Depressive symptoms were crucial in maintaining and spreading psychopathological manifestation in help-seeking youth. Findings suggest that preventive interventions focusing on negative and disorganization symptoms and impaired functioning in CHR-P youth are needed. Further research exploring longitudinal course of symptom co-occurrence is warranted.