Validation of "prodromal" criteria to detect individuals at ultra high risk of psychosis: 2 year follow-up.
BACKGROUND
Identification of individuals "prodromal" for schizophrenia and other psychotic disorders relies on criteria that predict onset within a brief period. Previous trials and biological research have been predicated on the view that certain "ultra high risk" (UHR) criteria detect "the prodrome", but there is a need to test the validity of these criteria.


OBJECTIVE
To assess the predictive validity of the UHR criteria in a clinical population.


METHODS
The presence of UHR criteria was determined in 292 help-seeking individuals. At 2 year follow-up the number of new cases of psychotic disorder was assessed.


RESULTS
The criteria significantly predicted onset of psychotic disorder within 2 years. The transition rate of 16% was much lower than in initial cohorts (over 40%).


CONCLUSIONS
The predictive validity of UHR criteria depends on the sample to which they are applied. Although young help-seekers meeting these criteria are at greater risk of psychotic disorder than those who do not meet them, caution is needed in their management, since a high transition rate can no longer be assumed.
Yung
Alison R
AR
Orygen Research Centre and University of Melbourne, Department of Psychiatry, Parkville 3052, Victoria, Australia. aryung@unimelb.edu.au
Nelson
Barnaby
B
Stanford
Carrie
C
Simmons
Magenta B
MB
Cosgrave
Elizabeth M
EM
Killackey
Eoin
E
Phillips
Lisa J
LJ
Bechdolf
Andreas
A
Buckby
Joe
J
McGorry
Patrick D
PD