Baseline differences in clinical symptomatology between ultra high risk subjects with and without a transition to psychosis.
BACKGROUND
The chance of transition to psychosis in patients at Ultra High Risk for developing psychosis (UHR) is 10-15%. The aim of present study was to investigate differences in baseline clinical symptomatology, general level of functioning (GAF-score) and genetic risk between UHR patients who did (UHR+T) or did not (UHR+NT) make a transition to psychosis. Sharpening UHR inclusion criteria may aid in improving prediction of transition to psychosis.


METHODS
The study sample was taken from 285 patients who were examined within the Dutch Prediction of Psychosis Study (DUPS) at the Academic Medical Center of the University of Amsterdam, the Netherlands. Out of 73 included UHR subjects, 18 made a transition to psychosis. Psychopathology was investigated with the Structured Interview for Prodromal Syndromes, Bonn Scale for the Assessment of Basic Symptoms and GAF-score. The follow-up period of the study was three years.


RESULTS
The UHR+T group showed more social anhedonia and withdrawal, more bizarre thinking and a lower GAF score at baseline than the UHR+NT group.


CONCLUSIONS
In agreement with the results of Cannon et al. [Cannon, T.D., Cadenhead, K., Cornblatt, B., Woods, S.W., Addington, J., Walker, E., Seidman, L.J., Perkins, D., Tsuang, M., McGlashan, T., Heinssen, R., 2008. Prediction of Psychosis in Youth at High Clinical Risk: A Multisite Longitudinal Study in North America. Arch. Gen. Psychiat. 65 (1) 28-37.], our study indicates that severity of specific symptoms at baseline is related to transition to psychosis in UHR subjects. These findings may contribute to a more accurate prediction of a first psychotic episode. Furthermore, symptoms that are increased at baseline in the UHR+T group could be a focus of cognitive behavioural therapy in the UHR period.
Velthorst
Eva
E
Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands. e.velthorst@amc.uva.nl
Nieman
Dorien H
DH
Becker
Hiske E
HE
van de Fliert
Reinaud
R
Dingemans
Peter M
PM
Klaassen
Rianne
R
de Haan
Lieuwe
L
van Amelsvoort
Thérèse
T
Linszen
Don H
DH
D000293:Adolescent; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis* / Q000235:genetics; D012565:Schizophrenic Psychology; D011795:Surveys and Questionnaires; D055815:Young Adult