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Clinical and functional characteristics of youth at clinical high-risk for psychosis who do not transition to psychosis

Published online by Cambridge University Press:  04 September 2018

Jean Addington ,
Jacqueline Stowkowy ,
Lu Liu ,
Kristin S. Cadenhead ,
Tyrone D. Cannon ,
Barbara A. Cornblatt ,
Thomas H. McGlashan ,
Diana O. Perkins ,
Larry J. Seidman  and
Ming T. Tsuang
...Show all authors
Jean Addington*
Affiliation:
Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
Jacqueline Stowkowy
Affiliation:
Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
Lu Liu
Affiliation:
Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
Kristin S. Cadenhead
Affiliation:
Department of Psychiatry, University of California San Diego, La Jolla, California, USA
Tyrone D. Cannon
Affiliation:
Department of Psychology, Yale University, New Haven, CT, USA
Barbara A. Cornblatt
Affiliation:
Department of Psychiatry, Zucker Hillside Hospital, Queens, NY, USA
Thomas H. McGlashan
Affiliation:
Department of Psychiatry, Yale University, New Haven, CT, USA
Diana O. Perkins
Affiliation:
Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
Larry J. Seidman
Affiliation:
Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
Ming T. Tsuang
Affiliation:
Department of Psychiatry, University of California San Diego, La Jolla, California, USA Institute of Genomic Medicine, University of California, La Jolla, CA, USA
Elaine F. Walker
Affiliation:
Department of Psychology, Emory University, Atlanta, GA, USA
Carrie E. Bearden
Affiliation:
Departments of Psychiatry and Biobehavioral Sciences and Psychology, University of California, Los Angeles, CA, USA
Daniel H. Mathalon
Affiliation:
Department of Psychiatry, University of California, San Francisco, USA Psychiatry Service, San Francisco, CA, USA
Olga Santesteban-Echarri
Affiliation:
Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
Scott W. Woods
Affiliation:
Department of Psychiatry, Yale University, New Haven, CT, USA
*
Author for correspondence: Jean Addington, E-mail: [email protected]
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Abstract

Background

Much of the interest in youth at clinical high risk (CHR) of psychosis has been in understanding conversion. Recent literature has suggested that less than 25% of those who meet established criteria for being at CHR of psychosis go on to develop a psychotic illness. However, little is known about the outcome of those who do not make the transition to psychosis. The aim of this paper was to examine clinical symptoms and functioning in the second North American Prodrome Longitudinal Study (NAPLS 2) of those individuals whose by the end of 2 years in the study had not developed psychosis.

Methods

In NAPLS-2 278 CHR participants completed 2-year follow-ups and had not made the transition to psychosis. At 2-years the sample was divided into three groups – those whose symptoms were in remission, those who were still symptomatic and those whose symptoms had become more severe.

Results

There was no difference between those who remitted early in the study compared with those who remitted at one or 2 years. At 2-years, those in remission had fewer symptoms and improved functioning compared with the two symptomatic groups. However, all three groups had poorer social functioning and cognition than healthy controls.

Conclusions

A detailed examination of the clinical and functional outcomes of those who did not make the transition to psychosis did not contribute to predicting who may make the transition or who may have an earlier remission of attenuated psychotic symptoms.

Keywords

Attenuated symptomsclinical high riskconversionfunctioningpsychosis
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 10 , July 2019 , pp. 1670 - 1677
Copyright
Copyright © Cambridge University Press 2018 

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