title: Deficits in the identification of pleasant odors predict the transition of an at-risk mental state to psychosis.
abstract: Existing knowledge of the relationship between olfactory identification (OI) ability and clinical risk of psychosis is inconsistent. To address this inconsistency, the aim of the present study was to identify the relationship between OI ability, with regard to the hedonic attributes of odors, and the risk of transition to psychosis in individuals with an ARMS.
  
  
  
  A group of 81 individuals meeting the ARMS criteria according to the Comprehensive Assessment of At Risk Mental State were at baseline administered with the University of Pennsylvania Smell Identification Test. The hedonic attributes of odorants were normatively established. Participants were followed up for transition to psychosis for a mean period of 36.1months (SD:27.5months).
  
  
  
  The presence of deficits in the identification of pleasant odors was found to be a risk factor for conversion from an ARMS to schizophrenia. The hazard ratio for each point in deficit scores in the Cox regression model was 1.455 (95% CI: 1.211-1.747), p<0.0001. Significant deficits in the identification of pleasant odors were associated with a risk for conversion at both early and late time points from baseline.
  
  
  
  The findings imply that the impaired identification of pleasant odorants may be a risk factor for the transition of an ARMS into a psychotic disorder, and highlights the need for further research of OI in "at-risk" cohorts, taking into account the hedonic attributes of odors.
authors.affiliation: Medical University of Łódź, Chair of Psychiatry, Department of Affective and Psychotic Disorders, ul. Czechosłowacka 8/10, 92-216 Łódź, Poland. Electronic address: magdalena.kotlicka-antczak@umed.lodz.pl.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Kotlicka-Antczak
authors.affiliation: Medical University of Łódź, Chair of Psychiatry, Department of Affective and Psychotic Disorders, ul. Czechosłowacka 8/10, 92-216 Łódź, Poland. Electronic address: agnieszka.pawelczyk@umed.lodz.pl.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Pawełczyk
authors.affiliation: Medical University of Łódź, Department of Pharmacology and Toxicology, ul. Żeligowskiego 7/9, 90-752 Łódź, Poland. Electronic address: michal.karbownik@umed.lodz.pl.
authors.forename: Michał S
authors.initials: MS
authors.lastname: Karbownik
authors.affiliation: Medical University of Łódź, Chair of Psychiatry, Department of Affective and Psychotic Disorders, ul. Czechosłowacka 8/10, 92-216 Łódź, Poland. Electronic address: tomasz.pawelczyk@umed.lodz.pl.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Pawełczyk
authors.affiliation: Medical University of Łódź, Chair of Psychiatry, Department of Affective and Psychotic Disorders, ul. Czechosłowacka 8/10, 92-216 Łódź, Poland. Electronic address: dominik.strzelecki@umed.lodz.pl.
authors.forename: Dominik
authors.initials: D
authors.lastname: Strzelecki
authors.affiliation: Adolescent Psychiatry Unit, Central Clinical Hospital of Medical University of Łódź, ul. Czechosłowacka 8/10, 92-216 Łódź, Poland. Electronic address: nzurner@gmail.com.
authors.forename: Natalia
authors.initials: N
authors.lastname: Żurner
authors.affiliation: Medical University of Łódź, Chair of Psychiatry, Department of Affective and Psychotic Disorders, ul. Czechosłowacka 8/10, 92-216 Łódź, Poland. Electronic address: malgorzata.urban@umed.lodz.pl.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Urban-Kowalczyk
mesh_terms: D000293:Adolescent; D000328:Adult; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D053208:Kaplan-Meier Estimate; D008297:Male; D009483:Neuropsychological Tests; D009812:Odorants; D000857:Olfaction Disorders / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D055696:Olfactory Perception; D062706:Prodromal Symptoms; D016016:Proportional Hazards Models; D011618:Psychotic Disorders / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D012307:Risk Factors; D012559:Schizophrenia / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D055815:Young Adult
keywords: At-risk mental state; Olfactory identification; Pleasant odors; Schizophrenia; Smell; Transition to psychosis