Background and Hypothesis This review examines the evolution and future prospects of prevention based on evaluation (PBE) for individuals at clinical high risk (CHR) of psychosis, drawing insights from the SHARP (Shanghai At Risk for Psychosis) study. It aims to assess the effectiveness of non-pharmacological interventions in preventing psychosis onset among CHR individuals. Study Design The review provides an overview of the developmental history of the SHARP study and its contributions to understanding the needs of CHR individuals. It explores the limitations of traditional antipsychotic approaches and introduces PBE as a promising framework for intervention. Study Results Three key interventions implemented by the SHARP team are discussed: nutritional supplementation based on niacin skin response blunting, precision transcranial magnetic stimulation targeting cognitive and brain functional abnormalities, and cognitive behavioral therapy for psychotic symptoms addressing symptomatology and impaired insight characteristics. Each intervention is evaluated within the context of PBE, emphasizing the potential for tailored approaches to CHR individuals. Conclusions The review highlights the strengths and clinical applications of the discussed interventions, underscoring their potential to revolutionize preventive care for CHR individuals. It also provides insights into future directions for PBE in CHR populations, including efforts to expand evaluation techniques and enhance precision in interventions.

中文翻译：

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基于对临床精神病高风险个体的评估的预防进展和未来方向：来自 SHARP 研究的见解

背景和假设本综述探讨了针对精神病临床高风险（CHR）个体的基于评估的预防（PBE）的演变和未来前景，汲取了 SHARP（上海精神病风险）研究的见解。其目的是评估非药物干预措施在预防 CHR 个体精神病发作方面的有效性。研究设计 该综述概述了 SHARP 研究的发展历史及其对了解 CHR 个人需求的贡献。它探讨了传统抗精神病药物的局限性，并引入 PBE 作为一个有前景的干预框架。研究结果讨论了 SHARP 团队实施的三项关键干预措施：基于烟酸皮肤反应减弱的营养补充、针对认知和脑功能异常的精确经颅磁刺激、以及针对精神病症状的认知行为疗法，以解决症状学和受损的洞察力特征。每项干预措施均在 PBE 的背景下进行评估，强调针对 CHR 个体量身定制方法的潜力。结论 该综述强调了所讨论的干预措施的优势和临床应用，强调了它们彻底改变 CHR 个体预防性护理的潜力。它还提供了对 CHR 人群 PBE 未来方向的见解，包括扩展评估技术和提高干预精度的努力。