96. An Open Label Study of Synthetic Psilocybin in Bipolar Type II Depression

Background: Despite increasingly re fi ned tools for identi-fying individuals at clinical high-risk for psychosis (CHR-P), less is known about the effectiveness of interventions for CHR-P. The signi fi cant clinical heterogeneity among CHR-P individuals is a notable barrier, suggesting that interventions may need to be personalized during this emerging phase of illness. To address these gaps, the current study examined two questions: (1) how do symptoms and functioning change in response to novel, personalized step-based intervention for CHR-P, and (2) how do baseline clinical and demographic factors in fl uence response to step-based care?

Methods: 38 individuals meeting CHR-P criteria (mean age ¼ 19.3) were rated by clinicians on attenuated psychotic symptoms and functioning at baseline and each week during 26 weeks of novel step-based care for CHR-P delivered in a specialized outpatient program. Linear mixed-effects models examined change over time in symptoms and functioning, and tested the effect of baseline covariates.

Results: Mixed-effects models found that attenuated psychotic symptoms decreased during the study period, while functioning did not signi fi cantly change. When examining baseline clinical and demographic factors as predictors of treatment response, a signi fi cant group by time interaction emerged whereby CHR-P individuals with more psychiatric comorbidities at baseline (indicating greater clinical complexity) improved in functioning during the study period relative to CHR-P individuals with fewer psychiatric comorbidities.

Conclusions: Attenuated psychotic symptoms decreased among all participants receiving outpatient step-based care. Individual differences in clinical complexity may predict functional response during the early phases of CHR-P treatment.