Outcomes of nontransitioned cases in a sample at ultra-high risk for psychosis

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Outcomes of nontransitioned cases in a sample at ultra-high risk for psychosis. / Lin, Ashleigh; Wood, Stephen J; Nelson, Barnaby; Beavan, Amanda; McGorry, Patrick; Yung, Alison R.

In: American Journal of Psychiatry, Vol. 172, No. 3, 01.03.2015, p. 249-58.

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Lin, Ashleigh ; Wood, Stephen J ; Nelson, Barnaby ; Beavan, Amanda ; McGorry, Patrick ; Yung, Alison R. / Outcomes of nontransitioned cases in a sample at ultra-high risk for psychosis. In: American Journal of Psychiatry. 2015 ; Vol. 172, No. 3. pp. 249-58.

Bibtex

@article{ad8aa86afd11480e89d9bf8742297e73,
title = "Outcomes of nontransitioned cases in a sample at ultra-high risk for psychosis",
abstract = "OBJECTIVE: Two-thirds of individuals identified as at ultra-high risk for psychosis do not develop psychotic disorder over the medium term. The authors examined outcomes in a group of such patients.METHOD: Participants were help-seeking individuals identified as being at ultra-high risk for psychosis 2-14 years previously. The 226 participants (125 female, 101 male) completed a follow-up assessment and had not developed psychosis. Their mean age at follow-up was 25.5 years (SD=4.8).RESULTS: At follow-up, 28% of the participants reported attenuated psychotic symptoms. Over the follow-up period, 68% experienced nonpsychotic disorders: mood disorder in 49%, anxiety disorder in 35%, and substance use disorder in 29%. For the majority (90%), nonpsychotic disorder was present at baseline, and it persisted for 52% of them. During follow-up, 26% of the cohort had remission of a disorder, but 38% developed a new disorder. Only 7% did not experience any disorder at baseline or during follow up. The incidence of nonpsychotic disorder was associated with more negative symptoms at baseline. Female participants experienced higher rates of persistent or recurrent disorder. Meeting criteria for brief limited intermittent psychotic symptoms at intake was associated with lower risk for persistent or recurrent disorder.CONCLUSIONS: Individuals at ultra-high risk for psychosis who do not transition to psychosis are at significant risk for continued attenuated psychotic symptoms, persistent or recurrent disorders, and incident disorders. Findings have implications for ongoing clinical care.",
keywords = "Adult, Anxiety Disorders, Australia, Female, Follow-Up Studies, Humans, Incidence, Male, Mood Disorders, Patient Care Management, Patient Outcome Assessment, Prognosis, Psychiatric Status Rating Scales, Psychotic Disorders, Recurrence, Risk Assessment, Substance-Related Disorders",
author = "Ashleigh Lin and Wood, {Stephen J} and Barnaby Nelson and Amanda Beavan and Patrick McGorry and Yung, {Alison R}",
year = "2015",
month = mar,
day = "1",
doi = "10.1176/appi.ajp.2014.13030418",
language = "English",
volume = "172",
pages = "249--58",
journal = "American Journal of Psychiatry",
issn = "0002-953X",
publisher = "American Psychiatric Publishing",
number = "3",

}

RIS

TY - JOUR

T1 - Outcomes of nontransitioned cases in a sample at ultra-high risk for psychosis

AU - Lin, Ashleigh

AU - Wood, Stephen J

AU - Nelson, Barnaby

AU - Beavan, Amanda

AU - McGorry, Patrick

AU - Yung, Alison R

PY - 2015/3/1

Y1 - 2015/3/1

N2 - OBJECTIVE: Two-thirds of individuals identified as at ultra-high risk for psychosis do not develop psychotic disorder over the medium term. The authors examined outcomes in a group of such patients.METHOD: Participants were help-seeking individuals identified as being at ultra-high risk for psychosis 2-14 years previously. The 226 participants (125 female, 101 male) completed a follow-up assessment and had not developed psychosis. Their mean age at follow-up was 25.5 years (SD=4.8).RESULTS: At follow-up, 28% of the participants reported attenuated psychotic symptoms. Over the follow-up period, 68% experienced nonpsychotic disorders: mood disorder in 49%, anxiety disorder in 35%, and substance use disorder in 29%. For the majority (90%), nonpsychotic disorder was present at baseline, and it persisted for 52% of them. During follow-up, 26% of the cohort had remission of a disorder, but 38% developed a new disorder. Only 7% did not experience any disorder at baseline or during follow up. The incidence of nonpsychotic disorder was associated with more negative symptoms at baseline. Female participants experienced higher rates of persistent or recurrent disorder. Meeting criteria for brief limited intermittent psychotic symptoms at intake was associated with lower risk for persistent or recurrent disorder.CONCLUSIONS: Individuals at ultra-high risk for psychosis who do not transition to psychosis are at significant risk for continued attenuated psychotic symptoms, persistent or recurrent disorders, and incident disorders. Findings have implications for ongoing clinical care.

AB - OBJECTIVE: Two-thirds of individuals identified as at ultra-high risk for psychosis do not develop psychotic disorder over the medium term. The authors examined outcomes in a group of such patients.METHOD: Participants were help-seeking individuals identified as being at ultra-high risk for psychosis 2-14 years previously. The 226 participants (125 female, 101 male) completed a follow-up assessment and had not developed psychosis. Their mean age at follow-up was 25.5 years (SD=4.8).RESULTS: At follow-up, 28% of the participants reported attenuated psychotic symptoms. Over the follow-up period, 68% experienced nonpsychotic disorders: mood disorder in 49%, anxiety disorder in 35%, and substance use disorder in 29%. For the majority (90%), nonpsychotic disorder was present at baseline, and it persisted for 52% of them. During follow-up, 26% of the cohort had remission of a disorder, but 38% developed a new disorder. Only 7% did not experience any disorder at baseline or during follow up. The incidence of nonpsychotic disorder was associated with more negative symptoms at baseline. Female participants experienced higher rates of persistent or recurrent disorder. Meeting criteria for brief limited intermittent psychotic symptoms at intake was associated with lower risk for persistent or recurrent disorder.CONCLUSIONS: Individuals at ultra-high risk for psychosis who do not transition to psychosis are at significant risk for continued attenuated psychotic symptoms, persistent or recurrent disorders, and incident disorders. Findings have implications for ongoing clinical care.

KW - Adult

KW - Anxiety Disorders

KW - Australia

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Incidence

KW - Male

KW - Mood Disorders

KW - Patient Care Management

KW - Patient Outcome Assessment

KW - Prognosis

KW - Psychiatric Status Rating Scales

KW - Psychotic Disorders

KW - Recurrence

KW - Risk Assessment

KW - Substance-Related Disorders

U2 - 10.1176/appi.ajp.2014.13030418

DO - 10.1176/appi.ajp.2014.13030418

M3 - Article

C2 - 25727537

VL - 172

SP - 249

EP - 258

JO - American Journal of Psychiatry

JF - American Journal of Psychiatry

SN - 0002-953X

IS - 3

ER -