Skip to main content
×
×
Home

Clinical and functional characteristics of youth at clinical high-risk for psychosis who do not transition to psychosis

  • Jean Addington (a1), Jacqueline Stowkowy (a1), Lu Liu (a1), Kristin S. Cadenhead (a2), Tyrone D. Cannon (a3), Barbara A. Cornblatt (a4), Thomas H. McGlashan (a5), Diana O. Perkins (a6), Larry J. Seidman (a7), Ming T. Tsuang (a2) (a8), Elaine F. Walker (a9), Carrie E. Bearden (a10), Daniel H. Mathalon (a11) (a12), Olga Santesteban-Echarri (a1) and Scott W. Woods (a5)...
Abstract
Background

Much of the interest in youth at clinical high risk (CHR) of psychosis has been in understanding conversion. Recent literature has suggested that less than 25% of those who meet established criteria for being at CHR of psychosis go on to develop a psychotic illness. However, little is known about the outcome of those who do not make the transition to psychosis. The aim of this paper was to examine clinical symptoms and functioning in the second North American Prodrome Longitudinal Study (NAPLS 2) of those individuals whose by the end of 2 years in the study had not developed psychosis.

Methods

In NAPLS-2 278 CHR participants completed 2-year follow-ups and had not made the transition to psychosis. At 2-years the sample was divided into three groups – those whose symptoms were in remission, those who were still symptomatic and those whose symptoms had become more severe.

Results

There was no difference between those who remitted early in the study compared with those who remitted at one or 2 years. At 2-years, those in remission had fewer symptoms and improved functioning compared with the two symptomatic groups. However, all three groups had poorer social functioning and cognition than healthy controls.

Conclusions

A detailed examination of the clinical and functional outcomes of those who did not make the transition to psychosis did not contribute to predicting who may make the transition or who may have an earlier remission of attenuated psychotic symptoms.

Copyright
Corresponding author
Author for correspondence: Jean Addington, E-mail: jmadding@ucalgary.ca
References
Hide All
Addington, J, Cornblatt, BA, Cadenhead, KS, Cannon, TD, McGlashan, TH, Perkins, DO, Seidman, LJ, Tsuang, MT, Walker, EF, Woods, SW and Heinssen, R (2011) At clinical high risk for psychosis: outcome for nonconverters. American Journal of Psychiatry 168, 800805.
Addington, J, Cadenhead, KS, Cornblatt, BA, Mathalon, DH, McGlashan, TH, Perkins, DO, Seidman, LJ, Tsuang, MT, Walker, EF, Woods, SW, Addington, JA and Cannon, TD (2012) North American prodrome Longitudinal Study (NAPLS 2): overview and recruitment. Schizophrenia Research 142, 7782.
Addington, J, Stowkowy, J, Cadenhead, KS, Cornblatt, BA, McGlashan, TH, Perkins, DO, Seidman, LJ, Tsuang, MT, Walker, EF, Woods, SW and Cannon, TD (2013) Early traumatic experiences in those at clinical high risk for psychosis. Early Intervention in Psychiatry 7, 300305.
Addington, J, Liu, L, Perkins, DO, Carrion, RE, Keefe, RS and Woods, SW (2016) The role of cognition and social functioning as predictors in the transition to psychosis for youth with attenuated psychotic symptoms. Schizophrenia Bulletin 43, 5763.
Armando, M, Pontillo, M, De, CF, Mazzone, L, Monducci, E, Lo, CN, Santonastaso, O, Pucciarini, ML, Vicari, S, Schimmelmann, BG and Schultze-Lutter, F (2015) Twelve-month psychosis-predictive value of the ultra-high risk criteria in children and adolescents. Schizophrenia Research 169, 186192.
Buchy, L, Cadenhead, KS, Cannon, TD, Cornblatt, BA, McGlashan, TH, Perkins, DO, Seidman, LJ, Tsuang, MT, Walker, EF, Woods, SW, Heinssen, R, Bearden, CE, Mathalon, D and Addington, J (2015) Substance use in individuals at clinical high risk of psychosis. Psychological Medicine 45, 22752284.
Cannon, TD, Cadenhead, K, Cornblatt, B, Woods, SW, Addington, J, Walker, E, Seidman, LJ, Perkins, D, Tsuang, M, McGlashan, T and Heinssen, R (2008) Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Archives of General Psychiatry 65, 2837.
Cannon, TD, Yu, C, Addington, J, Bearden, CE, Cadenhead, KS, Cornblatt, BA, Heinssen, R, Jeffries, CD, Mathalon, DH, McGlashan, TH, Perkins, DO, Seidman, LJ, Tsuang, MT, Walker, EF, Woods, SW and Kattan, MW (2016) An individualized risk calculator for research in prodromal psychosis. American Journal of Psychiatry 173, 980988.
Choi, J, Corcoran, CM, Fiszdon, JM, Stevens, M, Javitt, DC, Deasy, M, Haber, LC, Dewberry, MJ and Pearlson, GD (2017) Pupillometer-based neurofeedback cognitive training to improve processing speed and social functioning in individuals at clinical high risk for psychosis. Psychiatric. Rehabilitation Journal 40, 3342.
Cornblatt, BA, Auther, AM, Niendam, T, Smith, CW, Zinberg, J, Bearden, CE and Cannon, TD (2007) Preliminary findings for two new measures of social and role functioning in the prodromal phase of schizophrenia. Schizophrenia Bulletin 33, 688702.
Cornblatt, BA, Carrion, RE, Auther, A, McLaughlin, D, Olsen, RH, John, M and Correll, CU (2015) Psychosis prevention: a modified clinical high risk perspective from the recognition and prevention (RAP) program. American Journal of Psychiatry 172, 986994.
First, M, Spitzer, RL, Gibbon, M, Williams, B and Williams, JBW (1995) Structured Clinical Interview for DSM-IV Axis I Disorders, Patient Edition. Biometrics Research Department, New York State Psychiatric Institute, New York: New York.
Fusar-Poli, P, Bonoldi, I, Yung, AR, Borgwardt, S, Kempton, MJ, Valmaggia, L, Barale, F, Caverzasi, E and McGuire, P (2012 a) Predicting psychosis: meta-analysis of transition outcomes in individuals at high clinical risk. Archives of General Psychiatry 69, 220229.
Fusar-Poli, P, Deste, G, Smieskova, R, Barlati, S, Yung, AR, Howes, O, Stieglitz, RD, Vita, A, McGuire, P and Borgwardt, S (2012 b) Cognitive functioning in prodromal psychosis: a meta-analysisCognitive functioning in prodromal psychosis. Archives of General Psychiatry 69, 562571.
Fusar-Poli, P, Rutigliano, G, Stahl, D, Davies, C, De, MA, Ramella-Cravaro, V, Bonoldi, I and McGuire, P (2016) Long-term validity of the At Risk Mental State (ARMS) for predicting psychotic and non-psychotic mental disorders. European Psychiatry 42, 4954.
Fusar-Poli, P, Tantardini, M, De, SS, Ramella-Cravaro, V, Oliver, D, Kingdon, J, Kotlicka-Antczak, M, Valmaggia, L, Lee, J, Millan, MJ, Galderisi, S, Balottin, U, Ricca, V and McGuire, P (2017) Deconstructing vulnerability for psychosis: meta-analysis of environmental risk factors for psychosis in subjects at ultra high-risk. European Psychiatry 40, 6575.
Lee, TY, Kim, SN, Correll, CU, Byun, MS, Kim, E, Jang, JH, Kang, DH, Yun, JY and Kwon, JS (2014) Symptomatic and functional remission of subjects at clinical high risk for psychosis: a 2-year naturalistic observational study. Schizophrenia Research 156, 266271.
Lin, A, Wood, SJ, Nelson, B, Beavan, A, McGorry, P and Yung, AR (2015) Outcomes of nontransitioned cases in a sample at ultra-high risk for psychosis. American Journal of Psychiatry 172, 249258.
McGlashan, T, Walsh, BC and Woods, SW (2010) The Psychosis Risk Syndrome: Handbook for Diagnosis and Follow-up. New York: Oxford University Press.
McGorry, PD (2015) Early intervention in psychosis: obvious, effective, overdue. Journal of Nervous and Mental Disease 203, 310318.
Nelson, B, Yuen, HP, Wood, SJ, Lin, A, Spiliotacopoulos, D, Bruxner, A, Broussard, C, Simmons, M, Foley, DL, Brewer, WJ, Francey, SM, Amminger, GP, Thompson, A, McGorry, PD and Yung, AR (2013) Long-term follow-up of a group at ultra high risk (‘Prodromal’) for psychosis: the PACE 400 study. JAMA Psychiatry 70, 793802.
Nuechterlein, KH, Green, MF, Kern, RS, Baade, LE, Barch, DM, Cohen, JD, Essock, S, Fenton, WS, Frese, FJ III, Gold, JM, Goldberg, T, Heaton, RK, Keefe, RS, Kraemer, H, Mesholam-Gately, R, Seidman, LJ, Stover, E, Weinberger, DR, Young, AS, Zalcman, S and Marder, SR (2008) The MATRICS consensus cognitive battery, part 1: test selection, reliability, and validity. American Journal of Psychiatry 165, 203213.
Riecher-Rossler, A and Studerus, E (2017) Prediction of conversion to psychosis in individuals with an at-risk mental state: a brief update on recent developments. Current Opinion in Psychiatry 30, 209219.
Rutigliano, G, Valmaggia, L, Landi, P, Frascarelli, M, Cappucciati, M, Sear, V, Rocchetti, M, De, MA, Jones, C, Palombini, E, McGuire, P and Fusar-Poli, P (2016) Persistence or recurrence of non-psychotic comorbid mental disorders associated with 6-year poor functional outcomes in patients at ultra high risk for psychosis. Journal of Affective Disorders 203, 101110.
Saleem, MM, Stowkowy, J, Cadenhead, KS, Cannon, TD, Cornblatt, BA, McGlashan, TH, Perkins, DO, Seidman, LJ, Tsuang, MT, Walker, EF, Woods, SW and Addington, J (2013) Perceived discrimination in those at clinical high risk for psychosis. Early Intervention in Psychiatry 8, 7781.
Seidman, LJ, Shapiro, DI, Stone, WS, Woodberry, KA, Ronzio, A, Cornblatt, BA, Addington, J, Bearden, CE, Cadenhead, KS, Cannon, TD, Mathalon, DH, McGlashan, TH, Perkins, DO, Tsuang, MT, Walker, EF and Woods, SW (2016) Association of neurocognition with transition to psychosis: baseline functioning in the second phase of the North American prodrome longitudinal study. JAMA Psychiatry 73, 12391248.
Simon, AE, Borgwardt, S, Riecher-Rossler, A, Velthorst, E, de, HL and Fusar-Poli, P (2013) Moving beyond transition outcomes: meta-analysis of remission rates in individuals at high clinical risk for psychosis. Psychiatry Research 209, 266272.
Stowkowy, J, Liu, L, Cadenhead, KS, Cannon, TD, Cornblatt, BA, McGlashan, TH, Perkins, DO, Seidman, LJ, Tsuang, MT, Walker, EF, Woods, SW, Bearden, CE, Mathalon, DH and Addington, J (2016) Early traumatic experiences, perceived discrimination and conversion to psychosis in those at clinical high risk for psychosis. Social Psychiatry and Psychiatric Epidemiology 51, 497503.
Stowkowy, J, Liu, L, Cadenhead, KS, Tsuang, MT, Cannon, TD, Cornblatt, BA, McGlashan, TH, Woods, SW, Perkins, DO, Seidman, LJ, Walker, EF, Bearden, CE, Mathalon, DH and Addington, J (2017) Exploration of clinical high-risk dropouts. Schizophrenia Research 195, 579580.
van, OJ and Guloksuz, S (2017) A critique of the ‘ultra-high risk’ and ‘transition’ paradigm. World Psychiatry 16, 200206.
van Os, J, Linscott, RJ, Myin-Germeys, I, Delespaul, P and Krabbendam, L (2009) A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychological Medicine 39, 179195.
Webb, JR, Addington, J, Perkins, DO, Bearden, CE, Cadenhead, KS, Cannon, TD, Cornblatt, BA, Heinssen, RK, Seidman, LJ, Tarbox, SI, Tsuang, MT, Walker, EF, McGlashan, TH and Woods, SW (2015) Specificity of incident diagnostic outcomes in patients at clinical high risk for psychosis. Schizophrenia Bulletin 41, 10661075.
Woods, SW, Powers, AR III, Taylor, JH, Davidson, CA, Johannesen, JK, Addington, J, Perkins, DO, Bearden, CE, Cadenhead, KS, Cannon, TD, Cornblatt, BA, Seidman, LJ, Tsuang, MT, Walker, EF and McGlashan, TH (2018) Lack of diagnostic pluripotentiality in patients at clinical high risk for psychosis: specificity of comorbidity persistence and search for pluripotential subgroups. Schizophrenia Bulletin 44, 254263.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Type Description Title
UNKNOWN
Supplementary materials

Addington et al. supplementary material
Addington et al. supplementary material 1

 Unknown (127 KB)
127 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed