title: Distress in relation to attenuated psychotic symptoms in the ultra-high-risk population is not associated with increased risk of psychotic disorder.
abstract: OBJECTIVE
  The 'ultra-high-risk' criteria identify a clinical population at substantially increased risk for progressing to schizophrenia and other psychotic disorders. Although a number of clinical variables predictive of transition to psychotic disorder have been identified within this population, the predictive value of the level of distress associated with attenuated psychotic symptoms has not yet been examined. This was the aim of the present study.
  
  
  METHODS
  The level of distress (0-100) associated with attenuated psychotic symptoms was recorded for 70 ultra-high-risk (UHR) patients using the Comprehensive Assessment of At-Risk Mental State (CAARMS). Transition to psychosis was assessed over a 16-month follow-up period.
  
  
  RESULTS
  Of the 70 UHR patients, 15 transitioned to psychosis (21.4%). Of the four CAARMS subscales measuring attenuated positive symptoms, Perceptual Abnormalities was rated as the most distressing. There were no differences in CAARMS scales rated as the most distressing between those who transitioned to psychosis and those who did not. There was also no association between higher levels of distress associated with attenuated psychotic symptoms and transition to psychosis.
  
  
  CONCLUSIONS
  Although the findings require replication, they indicate that the degree of distress associated with attenuated psychotic symptoms should not be used as a criterion for enriching UHR samples for risk of frank psychotic disorder.
authors.affiliation: Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Lucy
authors.initials: L
authors.lastname: Power
authors.affiliation: Orygen Youth Health, Parkville, Victoria, Australia.
authors.forename: Andrea R
authors.initials: AR
authors.lastname: Polari
authors.affiliation: Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK.
authors.forename: Alison R
authors.initials: AR
authors.lastname: Yung
authors.affiliation: Centre for Youth Mental Health, Orygen Youth Health Research Centre, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Patrick D
authors.initials: PD
authors.lastname: McGorry
authors.affiliation: Centre for Youth Mental Health, Orygen Youth Health Research Centre, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Barnaby
authors.initials: B
authors.lastname: Nelson
mesh_terms: D000293:Adolescent; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D062706:Prodromal Symptoms; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000523:psychology*; D012307:Risk Factors; D012565:Schizophrenic Psychology; D013315:Stress, Psychological / Q000523:psychology*; D055815:Young Adult
keywords: clinical distress; prodrome; psychosis; ultra-high-risk