Outcomes of nontransitioned cases in a sample at ultra-high risk for psychosis

Ashleigh Lin, S. J. Wood, B. Nelson, A. Beavan, P.D. Mcgorry, A.R. Yung

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Abstract

© 2015, American Psychiatric Association. All rights reserved. Objective: Two-thirds of individuals identified as at ultra-high risk for psychosis do not develop psychotic disorder over the medium term. The authors examined outcomes in a group of such patients. Method: Participants were help-seeking individuals identified as being at ultra-high risk for psychosis 2-14 years previously. The 226 participants (125 female, 101 male) completed a follow-up assessment and had not developed psychosis. Their mean age at follow-up was 25.5 years (SD=4.8). Results: At follow-up, 28% of the participants reported attenuated psychotic symptoms.Over the follow-up period, 68% experienced nonpsychotic disorders: mood disorder in 49%, anxiety disorder in 35%, and substance use disorder in 29%. For the majority (90%), nonpsychotic disorder was present at baseline, and it persisted for 52% of them. During follow-up, 26% of the cohort had remission of a disorder, but 38% developed a new disorder. Only 7% did not experience any disorder at baseline or during follow up. The incidence of nonpsychotic disorder was associated with more negative symptoms at baseline. Female participants experienced higher rates of persistent or recurrent disorder. Meeting criteria for brief limited intermittent psychotic symptoms at intake was associated with lower risk for persistent or recurrent disorder. Conclusions: Individuals at ultra-high risk for psychosis who do not transition to psychosis are at signi ficant risk for continued attenuated psychotic symptoms, persistent or recurrent disorders, and incident disorders. Findings have implications for ongoing clinical care.
Original languageEnglish
Pages (from-to)249-258
JournalAmerican Journal of Psychiatry
Volume172
Issue number3
DOIs
Publication statusPublished - 1 Mar 2015

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Psychotic Disorders
Anxiety Disorders
Mood Disorders
Substance-Related Disorders
Incidence

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Lin, Ashleigh ; Wood, S. J. ; Nelson, B. ; Beavan, A. ; Mcgorry, P.D. ; Yung, A.R. / Outcomes of nontransitioned cases in a sample at ultra-high risk for psychosis. In: American Journal of Psychiatry. 2015 ; Vol. 172, No. 3. pp. 249-258.
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Outcomes of nontransitioned cases in a sample at ultra-high risk for psychosis. / Lin, Ashleigh; Wood, S. J.; Nelson, B.; Beavan, A.; Mcgorry, P.D.; Yung, A.R.

In: American Journal of Psychiatry, Vol. 172, No. 3, 01.03.2015, p. 249-258.

Research output: Contribution to journalArticle

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AB - © 2015, American Psychiatric Association. All rights reserved. Objective: Two-thirds of individuals identified as at ultra-high risk for psychosis do not develop psychotic disorder over the medium term. The authors examined outcomes in a group of such patients. Method: Participants were help-seeking individuals identified as being at ultra-high risk for psychosis 2-14 years previously. The 226 participants (125 female, 101 male) completed a follow-up assessment and had not developed psychosis. Their mean age at follow-up was 25.5 years (SD=4.8). Results: At follow-up, 28% of the participants reported attenuated psychotic symptoms.Over the follow-up period, 68% experienced nonpsychotic disorders: mood disorder in 49%, anxiety disorder in 35%, and substance use disorder in 29%. For the majority (90%), nonpsychotic disorder was present at baseline, and it persisted for 52% of them. During follow-up, 26% of the cohort had remission of a disorder, but 38% developed a new disorder. Only 7% did not experience any disorder at baseline or during follow up. The incidence of nonpsychotic disorder was associated with more negative symptoms at baseline. Female participants experienced higher rates of persistent or recurrent disorder. Meeting criteria for brief limited intermittent psychotic symptoms at intake was associated with lower risk for persistent or recurrent disorder. Conclusions: Individuals at ultra-high risk for psychosis who do not transition to psychosis are at signi ficant risk for continued attenuated psychotic symptoms, persistent or recurrent disorders, and incident disorders. Findings have implications for ongoing clinical care.

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