Children who have a parent with a psychotic disorder present an increased risk of developing psychosis. It is unclear to date, however, what proportion of all psychosis cases in the population are captured by a familial high-risk for psychosis (FHR-P) approach. This is essential information for prevention research and health service planning, as it tells us the total proportion of psychosis cases that this high-risk approach would prevent if an effective intervention were developed. Through a prospective cohort study including all individuals born in Finland between January 1, 1987 and December 31, 1992, we examined the absolute risk and total proportion of psychosis cases captured by FHR-P and by a transdiagnostic familial risk approach (TDFR-P) based on parental inpatient hospitalization for any mental disorder. Outcomes of non-affective psychosis (ICD-10: F20-F29) and schizophrenia (ICD-10: F20) were identified in the index children up to December 31, 2016. Of the index children (N=368,937), 1.5% (N=5,544) met FHR-P criteria and 10.3% (N=38,040) met TDFR-P criteria. By the study endpoint, 1.9% (N=6,966) of the index children had been diagnosed with non-affective psychosis and 0.5% (N=1,846) with schizophrenia. In terms of sensitivity, of all non-affective psychosis cases in the index children, 5.2% (N=355) were captured by FHR-P and 20.6% (N=1,413) by TDFR-P approaches. The absolute risk of non-affective psychosis was 6.4% in those with FHR-P, and 3.7% in those with TDFR-P. There was notable variation in the sensitivity and total proportion of FHR-P and TDFR-P cases captured based on the age at which FHR-P/TDFR-P were determined. The absolute risk for psychosis, however, was relatively time invariant. These metrics are essential to inform intervention strategies for psychosis risk requiring pragmatic decision-making.

中文翻译：

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家族高风险方法预测未来精神病的敏感性：一项总人口研究


父母患有精神病的儿童患精神病的风险会增加。然而，迄今为止尚不清楚通过家族性精神病高风险 (FHR-P) 方法捕获的所有精神病病例占人口的比例有多少。这是预防研究和卫生服务规划的重要信息，因为它告诉我们，如果制定有效的干预措施，这种高风险方法可以预防的精神病病例的总比例。通过一项前瞻性队列研究，包括 1987 年 1 月 1 日至 1992 年 12 月 31 日期间出生在芬兰的所有个体，我们检查了 FHR-P 和跨诊断家族风险方法 (TDFR-P) 捕获的精神病病例的绝对风险和总比例基于父母因任何精神障碍住院的情况。截至 2016 年 12 月 31 日，在指标儿童中确定了非情感性精神病（ICD-10：F20-F29）和精神分裂症（ICD-10：F20）的结果。在指标儿童（N = 368,937）中，1.5％（ N=5,544）符合 FHR-P 标准，10.3%（N=38,040）符合 TDFR-P 标准。截至研究终点，1.9% (N=6,966) 的指标儿童被诊断为非情感性精神病，0.5% (N=1,846) 被诊断为精神分裂症。就敏感性而言，在指标儿童的所有非情感性精神病病例中，FHR-P 方法捕获了 5.2%（N=355），TDFR-P 方法捕获了 20.6%（N=1,413）。 FHR-P 患者发生非情感性精神病的绝对风险为 6.4%，TDFR-P 患者发生非情感性精神病的绝对风险为 3.7%。根据确定 FHR-P/TDFR-P 的年龄，捕获的 FHR-P 和 TDFR-P 病例的敏感性和总比例存在显着差异。然而，精神病的绝对风险相对不随时间变化。 这些指标对于为需要务实决策的精神病风险干预策略提供信息至关重要。