title: Prospective study of adolescents with subsyndromal psychosis: characteristics and outcome.
abstract: OBJECTIVE
  The aim of this study was to examine the characteristics and outcome of adolescents with psychotic disorder not otherwise specified (PsyNOS) and brief psychotic disorder (BrPsy), two neglected subsyndromal diagnostic entities.
  
  
  METHODS
  As part of an ongoing, naturalistic study investigating adolescents considered to be prodromal for schizophrenia, 29 youngsters (mean age, 16.2 +/- 2.7 years) with PsyNOS or BrPsy were identified as theoretically at highest risk for schizophrenia and followed for over 6 (mean, 22.8 +/- 19.4) months.
  
  
  RESULTS
  Contrary to our expectations, only 7 of the 26 individuals (27.0%) with follow-up data developed schizophrenia or schizoaffective disorder, and only 2 subjects (7.7%) retained their diagnosis of BrPsy/PsyNOS. The most frequent other diagnoses at follow-up were mood disorders (34.6%), personality disorders (11.5%), and obsessive-compulsive disorder (7.7%). Regarding severity of outcome, 38.5% of the patients progressed to a syndromal psychotic disorder, 23.1% continued to have attenuated positive symptoms, and 38.4% improved to having attenuated negative symptoms only, or no positive or negative symptoms. BrPsy was associated with lower maximum levels of negative symptoms (p = 0.02) and higher likelihood of symptom remission (p = 0.02).
  
  
  CONCLUSIONS
  This study indicates that psychotic symptoms not fulfilling criteria for schizophrenia or a psychotic mood disorder are unreliable predictors of a syndromal psychotic disorder outcome at 2 years. Long-term studies of PsyNOS and BrPsy are needed to clarify where these disorders fall in the developmental course of schizophrenia.
authors.affiliation: The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY 11004, USA. ccorrell@lij.edu
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Correll
authors.forename: Todd
authors.initials: T
authors.lastname: Lencz
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Smith
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Auther
authors.forename: Emilie Y
authors.initials: EY
authors.lastname: Nakayama
authors.forename: Lauren
authors.initials: L
authors.lastname: Hovey
authors.forename: Ruth
authors.initials: R
authors.lastname: Olsen
authors.forename: Manoj
authors.initials: M
authors.lastname: Shah
authors.forename: Carmel
authors.initials: C
authors.lastname: Foley
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Cornblatt
mesh_terms: D000293:Adolescent; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D012559:Schizophrenia / Q000209:etiology; D012565:Schizophrenic Psychology; D012569:Schizotypal Personality Disorder / Q000209:etiology / Q000523:psychology; D012959:Socioeconomic Factors; D016896:Treatment Outcome