Psychosocial outcome in patients at clinical high risk of psychosis: a prospective follow-up.
OBJECTIVE
In patients at clinical high risk (CHR) of psychosis, transition to psychosis has been the focus of recent studies. Their broader outcome has received less attention. We studied psychosocial state and outcome in CHR patients.


METHODS
In the European Prediction of Psychosis Study, 244 young help-seeking CHR patients were assessed with the Strauss and Carpenter Prognostic Scale (SCPS) at baseline, and 149 (61.1%) of them were assessed for the second time at the 18-month follow-up. The followed patients were classified into poor and good outcome groups.


RESULTS
Female gender, ever-married/cohabitating relationship, and good working/studying situation were associated with good baseline SCPS scores. During follow-up, patients' SCPS scores improved significantly. Good follow-up SCPS scores were predicted by higher level of education, good working/studying status at baseline, and white ethnicity. One-third of the followed CHR patients had poor global outcome. Poor working/studying situation and lower level of education were associated with poor global outcome. Transition to psychosis was associated with baseline, but not with follow-up SCPS scores or with global outcome.


CONCLUSIONS
The majority of CHR patients experience good short-term recovery, but one-third have poor psychosocial outcome. Good working situation is the major indicator of good outcome, while low level of education and non-white ethnicity seem to be associated with poor outcome. Transition to psychosis has little effect on psychosocial outcome in CHR patients. In treating CHR patients, clinicians should focus their attention on a broader outcome, and not only on preventing transition to psychosis.
Department of Psychiatry, University of Turku, 20520 Turku, Finland. Raimo.K.R.Salokangas@tyks.fi
Raimo K R
RK
Salokangas
Dorien H
DH
Nieman
Markus
M
Heinimaa
Tanja
T
Svirskis
Sinikka
S
Luutonen
Tiina
T
From
Heinrich Graf
HG
von Reventlow
Georg
G
Juckel
Don
D
Linszen
Peter
P
Dingemans
Max
M
Birchwood
Paul
P
Patterson
Frauke
F
Schultze-Lutter
Joachim
J
Klosterkötter
Stephan
S
Ruhrmann
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D010361:Patients / Q000523:psychology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D017678:Sex Distribution; D012944:Social Support; D012959:Socioeconomic Factors; D055815:Young Adult