Despite significant advances, early detection and intervention regarding psychosis still face major obstacles. The Basel FePsy-study tries to contribute to optimising the methods for assessment of risk for psychosis, by describing individuals in an At Risk Mental State (ARMS) with and without later transition to psychosis as compared to healthy (HC) and depressive controls (DC) and by using a multidomain approach including not only psychopathology and clinical risk factors, but also neuropsychology, neurophysiology and neuroimaging.

60 ARMS subjects, 51 HC and 34 DC were investigated. 53 ARMS individuals could be followed up for up to 7 years.

21 ARMS individuals made the transition to psychosis (transition rate 34%). As compared to HC, they showed significant deficits in executive functions and working memory. Predictors of transition were certain attenuated psychotic and negative symptoms and certain cognitive deficits. In an integrated model for prediction of transition using these variables, the overall predictive accuracy was 80.9%, with a sensitivity of 83.3% and a specificity of 79.3%. Specificity of prediction could be further improved by EEG analysis. Furthermore, MRI showed specific differences between ARMS with and without later transition to psychosis.

Individuals at risk for psychosis do not only show psychopathological prodromes and social decline, but also neuropsychological impairments and EEG- as well as MRI-abnormalities. Hopefully in the near future, a clinical staging of individuals according to their risk for psychosis will be possible with corresponding stepwise early interventions.