TY - JOUR
T1 - 'At-risk' for psychosis research
T2 - Where are we heading?
AU - Lin, A.
AU - Nelson, B.
AU - Yung, A. R.
PY - 2012/12
Y1 - 2012/12
N2 - The 'at-risk' criteria are a useful paradigm for investigating the psychological, neurocognitive, neurobiological and genetic risk factors for psychosis, specifically schizophrenia. To date, the primary outcome of interest in at-risk research has been the development of psychotic disorder, whereby patients are categorized as either having 'transitioned' or 'not transitioned'. Despite the acceptance of this dichotomy, it is important to consider that the threshold at which psychotic symptoms progress from attenuated to frank 'psychotic disorder' is arbitrary and may be incorrect or meaningless in terms of neurobiological and functional changes associated with psychosis. This has implications for clinical care and the search for markers of schizophrenia. We present recent research suggesting that the term 'outcome' needs to be broadened to incorporate non-psychotic diagnoses, functioning and negative symptoms. Shifting the traditional notion of outcome is the future challenge for at-risk research, but the inclusion of outcomes other than psychosis is likely to result in better aetiological models of psychotic illness.
AB - The 'at-risk' criteria are a useful paradigm for investigating the psychological, neurocognitive, neurobiological and genetic risk factors for psychosis, specifically schizophrenia. To date, the primary outcome of interest in at-risk research has been the development of psychotic disorder, whereby patients are categorized as either having 'transitioned' or 'not transitioned'. Despite the acceptance of this dichotomy, it is important to consider that the threshold at which psychotic symptoms progress from attenuated to frank 'psychotic disorder' is arbitrary and may be incorrect or meaningless in terms of neurobiological and functional changes associated with psychosis. This has implications for clinical care and the search for markers of schizophrenia. We present recent research suggesting that the term 'outcome' needs to be broadened to incorporate non-psychotic diagnoses, functioning and negative symptoms. Shifting the traditional notion of outcome is the future challenge for at-risk research, but the inclusion of outcomes other than psychosis is likely to result in better aetiological models of psychotic illness.
KW - Non-psychotic disorders
KW - outcomes
KW - prodrome
KW - psychosis
KW - UHR
UR - http://www.scopus.com/inward/record.url?scp=84869400543&partnerID=8YFLogxK
U2 - 10.1017/S2045796012000388
DO - 10.1017/S2045796012000388
M3 - Review article
C2 - 22846110
AN - SCOPUS:84869400543
VL - 21
SP - 329
EP - 334
JO - Epidemiology and Psychiatric Sciences
JF - Epidemiology and Psychiatric Sciences
SN - 1121-189X
IS - 4
ER -