Olfactory identification deficits at identification as ultra-high risk for psychosis are associated with poor functional outcome

A Lin, W J Brewer, A R Yung, B Nelson, C Pantelis, S J Wood

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18 Citations (Scopus)
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BACKGROUND: We have previously reported that olfactory identification (OI) deficits are a promising premorbid marker of transition from ultra-high risk (UHR) to schizophrenia, but not to psychotic illness more generally. Whether this remains the case at longer follow-up, and whether there is decline in OI ability are unclear.

METHOD: The University of Pennsylvania Smell Identification Test (UPSIT) was administered to 81 participants at baseline (identification of risk for psychosis) and 254 individuals at follow-up. Forty-nine participants underwent UPSIT assessment at both time points. UPSIT scores were investigated at an average of 7.08years after identification of risk in relation to transition to psychosis, a diagnosis of schizophrenia, and psychosocial/functional outcome.

RESULTS: UPSIT scores at baseline and follow-up did not differ between participants who transitioned to psychosis and those who did not. Similarly, there were no significant differences on UPSIT scores at baseline or follow-up between individuals with a diagnosis of schizophrenia and transitioned individuals without schizophrenia. Those with a poor functional outcome showed significantly lower baseline UPSIT scores than participants with good outcome. There was no significant association between functional outcome and follow-up UPSIT scores. There were no significant changes in UPSIT over time for any group.

CONCLUSIONS: These results suggest that impaired OI is not a good marker of the onset of psychosis and schizophrenia, but may differentiate UHR individuals who experience a poor functional outcome, regardless of transition status.

Original languageEnglish
Pages (from-to)156-62
Number of pages7
JournalSchizophrenia Research
Issue number2-3
Early online date1 Dec 2014
Publication statusPublished - Feb 2015

Bibliographical note

Copyright © 2014 Elsevier B.V. All rights reserved.


  • Olfactory identification
  • Olfaction
  • Smell
  • At-risk
  • Ultra-high risk
  • Psychosis
  • Schizophrenia
  • Orbitofrontal cortex
  • Longitudinal


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