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Baseline demographics, clinical features and predictors of conversion among 200 individuals in a longitudinal prospective psychosis-risk cohort

Published online by Cambridge University Press:  02 March 2017

G. Brucato ,
M. D. Masucci ,
L. Y. Arndt ,
S. Ben-David ,
T. Colibazzi ,
C. M. Corcoran ,
A. H. Crumbley ,
F. M. Crump ,
K. E. Gill  and
D. Kimhy
...Show all authors
G. Brucato*
Affiliation:
The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
M. D. Masucci
Affiliation:
The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
L. Y. Arndt
Affiliation:
The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
S. Ben-David
Affiliation:
The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
T. Colibazzi
Affiliation:
The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
C. M. Corcoran
Affiliation:
The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
A. H. Crumbley
Affiliation:
City University of New York, New York, NY, USA
F. M. Crump
Affiliation:
The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
K. E. Gill
Affiliation:
Department of Psychology, The Catholic University of America, Washington, DC, USA
D. Kimhy
Affiliation:
The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
A. Lister
Affiliation:
The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
S. A. Schobel
Affiliation:
F. Hoffman-LaRoche A.G., Basel, Switzerland
L. H. Yang
Affiliation:
Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY, USA
J. A. Lieberman
Affiliation:
The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
R. R. Girgis
Affiliation:
The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, New York, NY, USA
*
*Address for correspondence: G. Brucato, Ph.D., The Center of Prevention and Evaluation, New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, Room 4818, New York, NY 10032, USA. (Email: gb2428@columbia.edu)
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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.

Method

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.

Keywords

Attenuated psychosisclinical high-risk for psychosisfirst episode of psychosisprodromal psychosisschizotypy
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 11 , August 2017 , pp. 1923 - 1935
Copyright
Copyright © Cambridge University Press 2017 

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Footnotes

†

These authors contributed equally to this work.

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