title: Baseline demographics, clinical features and predictors of conversion among 200 individuals in a longitudinal prospective psychosis-risk cohort.
abstract: BACKGROUND
  DSM-5 proposes an Attenuated Psychosis Syndrome (APS) for further investigation, based upon the Attenuated Positive Symptom Syndrome (APSS) in the Structured Interview for Psychosis-Risk Syndromes (SIPS). SIPS Unusual Thought Content, Disorganized Communication and Total Disorganization scores predicted progression to psychosis in a 2015 NAPLS-2 Consortium report. We sought to independently replicate this in a large single-site high-risk cohort, and identify baseline demographic and clinical predictors beyond current APS/APSS criteria.
  
  
  METHODS
  We prospectively studied 200 participants meeting criteria for both the SIPS APSS and DSM-5 APS. SIPS scores, demographics, family history of psychosis, DSM Axis-I diagnoses, schizotypy, and social and role functioning were assessed at baseline, with follow-up every 3 months for 2 years.
  
  
  RESULTS
  The conversion rate was 30% (n = 60), or 37.7% excluding participants who were followed under 2 years. This rate was stable across time. Conversion time averaged 7.97 months for 60% who developed schizophrenia and 15.68 for other psychoses. Mean conversion age was 20.3 for males and 23.5 for females. Attenuated odd ideas and thought disorder appear to be the positive symptoms which best predict psychosis in a logistic regression. Total negative symptom score, Asian/Pacific Islander and Black/African-American race were also predictive. As no Axis-I diagnosis or schizotypy predicted conversion, the APS is supported as a distinct syndrome. In addition, cannabis use disorder did not increase risk of conversion to psychosis.
  
  
  CONCLUSIONS
  NAPLS SIPS findings were replicated while controlling for clinical and demographic factors, strongly supporting the validity of the SIPS APSS and DSM-5 APS diagnosis.
authors.affiliation: The Center of Prevention and Evaluation,New York State Psychiatric Institute,Columbia University Medical Center,New York, NY,USA.
authors.forename: G
authors.initials: G
authors.lastname: Brucato
authors.affiliation: The Center of Prevention and Evaluation,New York State Psychiatric Institute,Columbia University Medical Center,New York, NY,USA.
authors.forename: M D
authors.initials: MD
authors.lastname: Masucci
authors.affiliation: The Center of Prevention and Evaluation,New York State Psychiatric Institute,Columbia University Medical Center,New York, NY,USA.
authors.forename: L Y
authors.initials: LY
authors.lastname: Arndt
authors.affiliation: The Center of Prevention and Evaluation,New York State Psychiatric Institute,Columbia University Medical Center,New York, NY,USA.
authors.forename: S
authors.initials: S
authors.lastname: Ben-David
authors.affiliation: The Center of Prevention and Evaluation,New York State Psychiatric Institute,Columbia University Medical Center,New York, NY,USA.
authors.forename: T
authors.initials: T
authors.lastname: Colibazzi
authors.affiliation: The Center of Prevention and Evaluation,New York State Psychiatric Institute,Columbia University Medical Center,New York, NY,USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Corcoran
authors.affiliation: City University of New York,New York, NY,USA.
authors.forename: A H
authors.initials: AH
authors.lastname: Crumbley
authors.affiliation: The Center of Prevention and Evaluation,New York State Psychiatric Institute,Columbia University Medical Center,New York, NY,USA.
authors.forename: F M
authors.initials: FM
authors.lastname: Crump
authors.affiliation: Department of Psychology,The Catholic University of America,Washington, DC,USA.
authors.forename: K E
authors.initials: KE
authors.lastname: Gill
authors.affiliation: The Center of Prevention and Evaluation,New York State Psychiatric Institute,Columbia University Medical Center,New York, NY,USA.
authors.forename: D
authors.initials: D
authors.lastname: Kimhy
authors.affiliation: The Center of Prevention and Evaluation,New York State Psychiatric Institute,Columbia University Medical Center,New York, NY,USA.
authors.forename: A
authors.initials: A
authors.lastname: Lister
authors.affiliation: F. Hoffman-LaRoche A.G.,Basel,Switzerland.
authors.forename: S A
authors.initials: SA
authors.lastname: Schobel
authors.affiliation: Department of Social and Behavioral Sciences,College of Global Public Health, New York University,New York, NY,USA.
authors.forename: L H
authors.initials: LH
authors.lastname: Yang
authors.affiliation: The Center of Prevention and Evaluation,New York State Psychiatric Institute,Columbia University Medical Center,New York, NY,USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Lieberman
authors.affiliation: The Center of Prevention and Evaluation,New York State Psychiatric Institute,Columbia University Medical Center,New York, NY,USA.
authors.forename: R R
authors.initials: RR
authors.lastname: Girgis
mesh_terms: D000293:Adolescent; D000328:Adult; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D062706:Prodromal Symptoms; D011379:Prognosis; D011618:Psychotic Disorders / Q000175:diagnosis / Q000503:physiopathology*; D012306:Risk; D012559:Schizophrenia / Q000175:diagnosis / Q000503:physiopathology*; D055815:Young Adult
keywords: Attenuated psychosis; clinical high-risk for psychosis; first episode of psychosis; prodromal psychosis; schizotypy