title: Transition and remission in adolescents at ultra-high risk for psychosis.
abstract: BACKGROUND
  Future success of early intervention initiatives to prevent the onset of psychosis will rely on the validity of methods to predict clinical outcome. Proper identification is particularly essential for young adolescents, as psychotic-like symptoms are often transitory during this period and mislabeling can lead to early stigmatization and unnecessary treatment. This article presents results from a prospective, naturalistic 2-year follow-up study of a cohort of young adolescents putatively at ultra-high risk (UHR) for psychosis.
  
  
  METHODS
  Seventy-two adolescents between 12 and 18years were recruited, fulfilling either UHR criteria or the basic symptom-based criterion cognitive disturbances (COGDIS). Incidence of transition as well as the remission rate from UHR status was calculated. Individuals who made a transition (UHR-P) were compared to those who did not (UHR-NP) and to those who remitted (UHR-R) on socio-demographic and clinical characteristics.
  
  
  RESULTS
  Fifty-seven UHR individuals completed the 2-year follow-up assessment. The confirmed transition rate was 15.6% and 35.3% still met UHR criteria. The remaining 49.1% had remitted from an initial UHR status. The UHR subgroups did not differ on socio-demographic or clinical variables at baseline.
  
  
  CONCLUSIONS
  Half of young adolescents meeting UHR criteria continue to experience prodromal or psychotic symptoms after 2 years. However, they are at least three times more likely to have remitted from their UHR status than to have made a transition to psychosis. In addition, baseline characteristics are not indicative of clinical outcome at follow-up. Our results emphasize the need for further improvement and stratification of relative risk factors for psychosis.
authors.affiliation: Department of Child and Adolescent Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, The Netherlands. Tim.Ziermans@ki.se
authors.forename: Tim B
authors.initials: TB
authors.lastname: Ziermans
authors.forename: Patricia F
authors.initials: PF
authors.lastname: Schothorst
authors.forename: Mirjam
authors.initials: M
authors.lastname: Sprong
authors.forename: Herman
authors.initials: H
authors.lastname: van Engeland
mesh_terms: D000293:Adolescent; D002648:Child; D003072:Cognition Disorders / Q000209:etiology*; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications* / Q000175:diagnosis*; D015203:Reproducibility of Results; D012307:Risk Factors; D018709:Statistics, Nonparametric; D016019:Survival Analysis