Three-year course of clinical symptomatology in young people at ultra high risk for transition to psychosis.
OBJECTIVE
The investigation into the course of ultra high risk (UHR) symptomatology of those patients who eventually do not meet the psychosis-threshold criteria within the 3-year timeframe of the study.


METHODS
The course of UHR symptoms, GAF score and employment status was investigated in 57 patients who did not make a transition to psychosis and who were examined within the Dutch Prediction of Psychosis Study in Amsterdam, the Netherlands.


RESULTS
At the 3-year follow-up, 75% of the patients who did not make a transition to psychosis had remitted from UHR status. With a Generalized Estimation Equation Model it was shown that this group recovered from positive (F = 52.7, P < 0.0001), negative (F = 24.3, P < 0.0001), disorganization (F = 14.4, P < 0.0001) and general symptoms (F = 25.0, P < 0.0001) within the timeframe of the study. In addition, the level of global functioning and likelihood of having a job and/or education significantly improved. The largest improvements occurred within the first year. UHR symptoms did not re-occur after improvement.


CONCLUSIONS
With the current UHR criteria, a large percentage of the included subjects appear to have transitory complaints and dysfunctioning. A refinement of the UHR criteria may diminish the chance of including 'false positives' in future UHR studies.
Velthorst
E
E
Department of Psychiatry, Academic Medical Centre, Amsterdam, the Netherlands. e.velthorst@amc.uva.nl
Nieman
D H
DH
Klaassen
R M C
RM
Becker
H E
HE
Dingemans
P M
PM
Linszen
D H
DH
De Haan
L
L
D000293:Adolescent; D004651:Employment / Q000523:psychology; D005069:Evaluation Studies as Topic; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008609:Mental Status Schedule / Q000592:standards*; D009426:Netherlands; D011379:Prognosis; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D012074:Remission Induction; D012306:Risk; D013997:Time Factors; D055815:Young Adult