Risk factors for transition to first episode psychosis among individuals with 'at-risk mental states'.
Recently developed criteria have been successful at identifying individuals at imminent risk of developing a psychotic disorder, but these criteria lead to 50-60% false positives. This study investigated whether measures of family history, peri-natal complications, premorbid social functioning, premorbid personality, recent life events and current symptoms would be able to improve predictions of psychosis in a group of young, help-seeking individuals who had been identified as being at risk. Individuals (N=74) were followed up at least 1 year after initial assessment. Half the sample went on to develop a psychotic disorder. The most reliable scale-based predictor was the degree of presence of schizotypal personality characteristics. However, individual items assessing odd beliefs/magical thinking, marked impairment in role functioning, blunted or inappropriate affect, anhedonia/asociality and auditory hallucinations were also highly predictive of transition, yielding good sensitivity (84%) and specificity (86%). These predictors are consistent with a picture of poor premorbid functioning that further declines in the period up to transition.
Sub-Department of Clinical Health Psychology, University College London, Gower Street, London WC1E 6BT, UK. o.mason@ucl.ac.uk
Oliver
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Mason
Mike
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Startup
Sean
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Halpin
Ulrich
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Schall
Agatha
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Conrad
Vaughan
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Carr
D000293:Adolescent; D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology*; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology*