TY - JOUR
T1 - The Ultra-High-Risk for psychosis groups
T2 - Evidence to maintain the status quo
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.
AB - 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.
KW - Long-term outcomes
KW - Symptom severity
KW - Transition
KW - UHR
KW - Ultra-High-Risk for psychosis
UR - http://www.scopus.com/inward/record.url?scp=85031741582&partnerID=8YFLogxK
U2 - 10.1016/j.schres.2017.09.003
DO - 10.1016/j.schres.2017.09.003
M3 - Article
C2 - 29055567
AN - SCOPUS:85031741582
SN - 0920-9964
VL - 195
SP - 543
EP - 548
JO - Schizophrenia Research
JF - Schizophrenia Research
ER -
