title: Ultra high-risk state for psychosis and non-transition: a systematic review.
abstract: BACKGROUND
  Most effort in ultra high-risk (UHR) research has been directed at defining the clinical and neurobiological characteristics of those UHR subjects who go on to develop psychosis. The characteristics and outcome of the remaining UHR subjects have remained relatively unexplored.
  
  
  METHODS
  We performed a systematic review of clinical UHR studies to investigate whether information was available on the characteristics and outcome of UHR subjects who did not convert to psychosis.
  
  
  RESULTS
  Of 2462 potentially relevant papers, 31 met inclusion criteria, i.e. 20 naturalistic and 11 intervention studies. On average 76% (range 46-92.6%) of the UHR patients made no transition to psychosis during follow-up (range 6 to 40 months). Nearly half of the studies provided no characteristics of those UHR subjects who did not develop psychosis. Six studies reported remission rates from initial UHR status (range 15.4% to 54.3%). Linear regression showed that more recent studies reported significantly lower transition rates as compared to earlier publications. An older mean age at baseline was associated with significant lower transition rates in publications with follow-ups exceeding 1 year.
  
  
  CONCLUSIONS
  Our review illustrates that the long-term outcome of UHR subjects that do not develop psychosis is to date under-investigated. The studies reporting remission rates suggest that UHR criteria capture a non-negligible proportion of subjects that do not convert to psychosis.
authors.affiliation: University Hospital of Psychiatry, University of Bern, 3010 Bern, Switzerland. andor.simon@bluewin.ch
authors.forename: Andor E
authors.initials: AE
authors.lastname: Simon
authors.forename: Eva
authors.initials: E
authors.lastname: Velthorst
authors.forename: Dorien H
authors.initials: DH
authors.lastname: Nieman
authors.forename: Don
authors.initials: D
authors.lastname: Linszen
authors.forename: Daniel
authors.initials: D
authors.lastname: Umbricht
authors.forename: Lieuwe
authors.initials: L
authors.lastname: de Haan
mesh_terms: D016208:Databases, Factual / Q000706:statistics & numerical data; D006801:Humans; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology