The Ultra-High-Risk for psychosis groups: Evidence to maintain the status quo

M. J. McHugh, P. D. McGorry, H. P. Yuen, I. B. Hickie, A. Thompson, L. de Haan, N. Mossaheb, S. Smesny, A. Lin, C. Markulev, M. Schloegelhofer, S. J. Wood, D. Nieman, J. A. Hartmann, M. Nordentoft, M. Schäfer, G. P. Amminger, A. Yung, B. Nelson

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Abstract

Individuals are considered Ultra-High-Risk (UHR) for psychosis if they meet a set of standardised criteria including presumed genetic vulnerability (Trait), or a recent history of Attenuated Psychotic Symptoms (APS) or Brief Limited Intermittent Psychotic Symptoms (BLIPS). Recent calls to revise these criteria have arisen from evidence that Trait, APS and BLIPS groups may transition to psychosis at different rates. Concurrently, it has become clear that the UHR status confers clinical risk beyond transition to psychosis. Specifically, most UHR individuals will not develop psychosis, but will experience high rates of non-psychotic disorders, persistent APS and poor long-term functional outcomes. Rather than focus on transition, the present study investigated whether UHR groups differ in their broader clinical risk profile by examining baseline clinical characteristics and long-term outcomes other than transition to psychosis. Four UHR groups were defined: Trait-only, APS-only, Trait + APS, and any BLIPS. Participants (N = 702) were recruited upon entry to early intervention services and followed-up over a period of up to 13 years (mean = 4.53, SD = 3.84). The groups evidenced similar symptom severity (SANS for negative symptoms, BPRS for positive and depression/anxiety symptoms) and psychosocial functioning (SOFAS, GAF, QLS) at baseline and follow-up as well as similar prevalence of non-psychotic disorders at follow-up. Our findings demonstrate that UHR groups evidence a similar clinical risk profile when we expand this beyond transition to psychosis, and consequently support maintaining the existing UHR criteria.

Original languageEnglish
Pages (from-to)543-548
Number of pages6
JournalSchizophrenia Research
Volume195
DOIs
Publication statusPublished - 1 May 2018

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Psychotic Disorders
Anxiety
Depression

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McHugh, M. J., McGorry, P. D., Yuen, H. P., Hickie, I. B., Thompson, A., de Haan, L., ... Nelson, B. (2018). The Ultra-High-Risk for psychosis groups: Evidence to maintain the status quo. Schizophrenia Research, 195, 543-548. https://doi.org/10.1016/j.schres.2017.09.003
McHugh, M. J. ; McGorry, P. D. ; Yuen, H. P. ; Hickie, I. B. ; Thompson, A. ; de Haan, L. ; Mossaheb, N. ; Smesny, S. ; Lin, A. ; Markulev, C. ; Schloegelhofer, M. ; Wood, S. J. ; Nieman, D. ; Hartmann, J. A. ; Nordentoft, M. ; Schäfer, M. ; Amminger, G. P. ; Yung, A. ; Nelson, B. / The Ultra-High-Risk for psychosis groups : Evidence to maintain the status quo. In: Schizophrenia Research. 2018 ; Vol. 195. pp. 543-548.
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McHugh, MJ, McGorry, PD, Yuen, HP, Hickie, IB, Thompson, A, de Haan, L, Mossaheb, N, Smesny, S, Lin, A, Markulev, C, Schloegelhofer, M, Wood, SJ, Nieman, D, Hartmann, JA, Nordentoft, M, Schäfer, M, Amminger, GP, Yung, A & Nelson, B 2018, 'The Ultra-High-Risk for psychosis groups: Evidence to maintain the status quo' Schizophrenia Research, vol. 195, pp. 543-548. https://doi.org/10.1016/j.schres.2017.09.003

The Ultra-High-Risk for psychosis groups : Evidence to maintain the status quo. / McHugh, M. J.; McGorry, P. D.; Yuen, H. P.; Hickie, I. B.; Thompson, A.; de Haan, L.; Mossaheb, N.; Smesny, S.; Lin, A.; Markulev, C.; Schloegelhofer, M.; Wood, S. J.; Nieman, D.; Hartmann, J. A.; Nordentoft, M.; Schäfer, M.; Amminger, G. P.; Yung, A.; Nelson, B.

In: Schizophrenia Research, Vol. 195, 01.05.2018, p. 543-548.

Research output: Contribution to journalArticle

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T1 - The Ultra-High-Risk for psychosis groups

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AU - McHugh, M. J.

AU - McGorry, P. D.

AU - Yuen, H. P.

AU - Hickie, I. B.

AU - Thompson, A.

AU - de Haan, L.

AU - Mossaheb, N.

AU - Smesny, S.

AU - Lin, A.

AU - Markulev, C.

AU - Schloegelhofer, M.

AU - Wood, S. J.

AU - Nieman, D.

AU - Hartmann, J. A.

AU - Nordentoft, M.

AU - Schäfer, M.

AU - Amminger, G. P.

AU - Yung, A.

AU - Nelson, B.

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Individuals are considered Ultra-High-Risk (UHR) for psychosis if they meet a set of standardised criteria including presumed genetic vulnerability (Trait), or a recent history of Attenuated Psychotic Symptoms (APS) or Brief Limited Intermittent Psychotic Symptoms (BLIPS). Recent calls to revise these criteria have arisen from evidence that Trait, APS and BLIPS groups may transition to psychosis at different rates. Concurrently, it has become clear that the UHR status confers clinical risk beyond transition to psychosis. Specifically, most UHR individuals will not develop psychosis, but will experience high rates of non-psychotic disorders, persistent APS and poor long-term functional outcomes. Rather than focus on transition, the present study investigated whether UHR groups differ in their broader clinical risk profile by examining baseline clinical characteristics and long-term outcomes other than transition to psychosis. Four UHR groups were defined: Trait-only, APS-only, Trait + APS, and any BLIPS. Participants (N = 702) were recruited upon entry to early intervention services and followed-up over a period of up to 13 years (mean = 4.53, SD = 3.84). The groups evidenced similar symptom severity (SANS for negative symptoms, BPRS for positive and depression/anxiety symptoms) and psychosocial functioning (SOFAS, GAF, QLS) at baseline and follow-up as well as similar prevalence of non-psychotic disorders at follow-up. Our findings demonstrate that UHR groups evidence a similar clinical risk profile when we expand this beyond transition to psychosis, and consequently support maintaining the existing UHR criteria.

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McHugh MJ, McGorry PD, Yuen HP, Hickie IB, Thompson A, de Haan L et al. The Ultra-High-Risk for psychosis groups: Evidence to maintain the status quo. Schizophrenia Research. 2018 May 1;195:543-548. https://doi.org/10.1016/j.schres.2017.09.003