title: Emotion recognition as a predictor of transition to a psychotic disorder in ultra-high risk participants.
abstract: OBJECTIVE
  Recent research has shown emotion recognition to be impaired in individuals at ultra-high risk (UHR) for developing a psychotic disorder compared to healthy controls. This longitudinal study aimed to examine whether disturbed emotion recognition measured in UHR participants at baseline predicts transition to a psychotic disorder within 12months.
  
  
  METHODS
  Thirty-seven UHR participants aged 13-22years participated in the study. At baseline participants completed face and prosody emotion recognition tasks, as well as measures of psychopathology, functioning, and IQ. Transition to a psychotic disorder over 12months was the primary outcome. A series of Cox regressions was performed with emotion recognition as the predictor variable, while controlling for covariates, with time to transition to a psychotic disorder as the dependent variable.
  
  
  RESULTS
  Eleven (29.7%) of the 37 participants transitioned to a psychotic disorder over the 12-month follow-up period. Total face or prosody emotion recognition accuracy was not predictive of transition to a psychotic disorder. However, examination of recognition of specific emotions, while controlling for positive, negative and global symptoms and functioning, revealed that accuracy in identifying neutral (p=.037) and fearful (p=.015) emotion predicted transition to a psychotic disorder. Specifically, lower accuracy in identifying neutral emotion and higher accuracy in identifying fearful emotion were predictive of transition to a psychotic disorder within 12months. Examination of the separate modalities revealed that this finding held for face but not for prosody emotion recognition.
  
  
  CONCLUSIONS
  These findings suggest that emotion recognition abilities may be prognostic for the development of psychotic disorders, but further studies are needed.
authors.affiliation: Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Australia. Electronic address: kallott@unimelb.edu.au.
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Allott
authors.affiliation: Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Australia; Department of Child and Adolescent Psychiatry, Medical University Vienna, Austria.
authors.forename: Miriam R
authors.initials: MR
authors.lastname: Schäfer
authors.affiliation: Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Australia; East Sussex Early Intervention in Psychosis Service, Sussex Partnership NHS Foundation Trust, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Thompson
authors.affiliation: Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Australia.
authors.forename: Barnaby
authors.initials: B
authors.lastname: Nelson
authors.affiliation: Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Bendall
authors.affiliation: Melbourne Neuropsychiatry Centre, The University of Melbourne, Australia.
authors.forename: Cali F
authors.initials: CF
authors.lastname: Bartholomeusz
authors.affiliation: Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Australia.
authors.forename: Hok Pan
authors.initials: HP
authors.lastname: Yuen
authors.affiliation: Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Australia.
authors.forename: Patrick D
authors.initials: PD
authors.lastname: McGorry
authors.affiliation: Department of Child and Adolescent Psychiatry, Medical University Vienna, Austria.
authors.forename: Monika
authors.initials: M
authors.lastname: Schlögelhofer
authors.affiliation: Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Australia; Department of Psychiatry and Psychotherapy, University of Cologne, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Bechdolf
authors.affiliation: Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Australia; Department of Child and Adolescent Psychiatry, Medical University Vienna, Austria.
authors.forename: G Paul
authors.initials: GP
authors.lastname: Amminger
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D004644:Emotions / Q000502:physiology*; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications* / Q000175:diagnosis*; D021641:Recognition, Psychology / Q000502:physiology*; D012044:Regression Analysis; D012306:Risk; D055815:Young Adult
keywords: Affect recognition; Conversion; Early psychosis; Fear; Neutral emotion; Trait marker