title: Current status specifiers for patients at clinical high risk for psychosis.
abstract: BACKGROUND
  Longitudinal studies of the clinical high risk (CHR) syndrome for psychosis have emphasized the conversion vs non-conversion distinction and thus far have not focused intensively on classification among non-converters. The present study proposes a system for classifying CHR outcomes over time when using the Structured Interview for Psychosis-risk Syndromes and evaluates its validity.
  
  
  METHODS
  The system for classifying CHR outcomes is referred to as "current status specifiers," with "current" meaning over the month prior to the present evaluation and "specifiers" indicating a set of labels and descriptions of the statuses. Specifiers for four current statuses are described: progression, persistence, partial remission, and full remission. Data from the North American Prodromal Longitudinal Study were employed to test convergent, discriminant, and predictive validity of the current status distinctions.
  
  
  RESULTS
  Validity analyses partly supported current status distinctions. Social and role functioning were more impaired in progressive and persistent than in remitted patients, suggesting a degree of convergent validity. Agreement between CHR current statuses and current statuses for a different diagnostic construct (DSM-IV Major Depression) was poor, suggesting discriminant validity. The proportion converting to psychosis within a year was significantly higher in cases meeting progression criteria than in those meeting persistence criteria and tended to be higher than in those meeting full remission criteria, consistent with a degree of predictive validity.
  
  
  CONCLUSIONS
  CHR syndrome current status specifiers could offer a potentially valid and useful description of current clinical status among non-converters. Study in additional samples is needed.
authors.affiliation: Department of Psychiatry, Yale University, New Haven, CT, United States. Electronic address: scott.woods@yale.edu.
authors.forename: Scott W
authors.initials: SW
authors.lastname: Woods
authors.affiliation: Department of Psychiatry, Yale University, New Haven, CT, United States.
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Walsh
authors.affiliation: Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Jean
authors.initials: J
authors.lastname: Addington
authors.affiliation: Department of Psychiatry, UCSD, San Diego, CA, United States.
authors.forename: Kristin S
authors.initials: KS
authors.lastname: Cadenhead
authors.affiliation: Department of Psychology, Yale University, New Haven, CT, United States.
authors.forename: Tyrone D
authors.initials: TD
authors.lastname: Cannon
authors.affiliation: Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, United States.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Cornblatt
authors.affiliation: Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, MD, United States.
authors.forename: Robert
authors.initials: R
authors.lastname: Heinssen
authors.affiliation: Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Diana O
authors.initials: DO
authors.lastname: Perkins
authors.affiliation: Department of Psychiatry, Harvard Medical School, Boston, MA, United States.
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Seidman
authors.affiliation: Department of Psychiatry, Yale University, New Haven, CT, United States.
authors.forename: Sarah I
authors.initials: SI
authors.lastname: Tarbox
authors.affiliation: Department of Psychiatry, UCSD, San Diego, CA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States.
authors.forename: Ming T
authors.initials: MT
authors.lastname: Tsuang
authors.affiliation: Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, United States.
authors.forename: Elaine F
authors.initials: EF
authors.lastname: Walker
authors.affiliation: Department of Psychiatry, Yale University, New Haven, CT, United States.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: McGlashan
mesh_terms: D018450:Disease Progression; D006801:Humans; D007406:Interview, Psychological; D008137:Longitudinal Studies; D011618:Psychotic Disorders / Q000145:classification* / Q000175:diagnosis / Q000628:therapy; D012306:Risk
keywords: Clinical high risk; Course of illness; Current status; Psychosis; Risk syndrome