Follow-up of subjects with suspected pre-psychotic state in Taiwan.
OBJECTIVE
To describe the outcomes of subjects with suspected pre-psychotic state in Taiwan.


METHODS
A prospective clinical observation was performed on subjects recruited by referrals from a community-based population. Three pre-psychotic risk groups were established by means of clinical interviews: an ultra-high risk group (UHR; 59 subjects), an intermediate-risk group (IRG; 46 subjects), and a marginal-risk group (MRG; 48 subjects). Also recruited were 60 subjects with first-episode psychosis (FEP) and 144 normal controls (NC group). All subjects were aged 16 to 32 years.


RESULTS
Of the 59 UHR subjects, 21 (35.6%) converted to FEP, including 15 with schizophrenia (6 had relatively brief positive yet persistent prominent negative symptoms), 2 with schizophreniform disorder, 1 with schizoaffective disorder, 2 with brief psychotic disorder, and 1 with bipolar disorder. The cumulative±SE rate of conversion to psychosis was 21.7%±5.4% at 6 months, 28.2%±6.2% at 12 months, 30.4%±6.4% at 18 months, and 33.3%±6.8% at 24 months. The UHR subjects who converted had a higher rate of initial antipsychotic use than those who did not convert. Only half of the IRG and two-thirds of the MRG subjects received follow-up, and none of them developed FEP.


CONCLUSIONS
Our results lent support to both sides of the current debate regarding establishing a new diagnostic category of "psychosis risk syndrome." The divergent trajectories of the UHR subjects deserve more clinical attention, especially with regard to the use of antipsychotics and the presence of a group with prominent negative symptoms.
Department of Psychiatry, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
Chen-Chung
CC
Liu
Meng-Chuan
MC
Lai
Chih-Min
CM
Liu
Yen-Nan
YN
Chiu
Ming H
MH
Hsieh
Tzung-Jeng
TJ
Hwang
Yi-Ling
YL
Chien
Wei J
WJ
Chen
Mau-Sun
MS
Hua
Ping-Chuan
PC
Hsiung
Ya-Chuan
YC
Huang
Hai-Gwo
HG
Hwu
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology; D012111:Residence Characteristics; D016019:Survival Analysis; D013624:Taiwan; D055815:Young Adult