Predicting Psychosis: Meta-analysis of Transition Outcomes in Individuals at High Clinical Risk
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CONTEXT: A substantial proportion of people at clinical high risk of psychosis will develop a psychotic disorder over time. However, the risk of transition to psychosis varies between centers, and some recent work suggests that the risk of transition may be declining. OBJECTIVE: To quantitatively examine the literature to date reporting the transition risk to psychosis in subjects at clinical high risk. DATA SOURCES: The electronic databases were searched until January 2011. All studies reporting transition risks in patients at clinical high risk were retrieved. STUDY SELECTION: Twenty-seven studies met the inclusion criteria, comprising a total of 2502 patients. DATA EXTRACTION: Transition risks, as well as demographic, clinical, and methodologic variables, were extracted from each publication or obtained directly from its authors. DATA SYNTHESIS: There was a consistent transition risk, independent of the psychometric instruments used, of 18% after 6 months of follow-up, 22% after 1 year, 29% after 2 years, and 36% after 3 years. Significant moderators accounting for heterogeneity across studies and influencing the transition risks were the age of participants, publication year, treatments received, and diagnostic criteria used. There was no publication bias, and a sensitivity analysis confirmed the robustness of the core findings. CONCLUSIONS: The state of clinical high risk is associated with a very high risk of developing psychosis within the first 3 years of clinical presentation, and the risk progressively increases across this period. The transition risk varies with the age of the patient, the nature of the treatment provided, and the way the syndrome and transition to psychosis are defined.
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Deserno, L., Heinz, A., & Schlagenhauf, F. (2017) · Schizophrenia Research · doi:10.1016/j.schres.2016.10.004 · Cited by 31 · see citing works
Nigral stress-induced dopamine release in clinical high risk and antipsychotic-naïve schizophrenia
Tseng, H.-H., Watts, J. J., Kiang, M., Suridjan, I., Wilson, A. A., Houle, S., Rusjan, P. M., & Mizrahi, R. (2018) · Schizophrenia Bulletin · doi:10.1093/schbul/sbx042 · Cited by 31 · see citing works
Preventing discrimination based on psychiatric risk biomarkers
Brannan, C., Foulkes, A. L., & Lázaro‐Muñoz, G. (2019) · American Journal of Medical Genetics Part B: Neuropsychiatric Genetics · doi:10.1002/ajmg.b.32629 · Cited by 22 · see citing works
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Self-citationProgression from unipolar depression to schizophrenia.
Musliner, K. L., Munk‐Olsen, T., Mors, O., & Østergaard, S. D. (2017) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12663 · Cited by 21 · see citing works
Omega‐3 fatty acid in ultra‐high‐risk psychosis: A systematic review based on functional outcome
Susai, S. R., Sabherwal, S., Mongan, D., Föcking, M., & Cotter, D. R. (2022) · Early Intervention in Psychiatry · doi:10.1111/eip.13133 · Cited by 19 · see citing works
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Wiedemann, A., Stochl, J., Russo, D., Patel, U., Ashford, P.-A., Ali, N., Jones, P. B., & Perez, J. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.10.073 · Cited by 9 · see citing works
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- Authors
- Fusar-Poli, P.
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2012-03-01
- Volume
- 69
- Issue
- 3
- Pages
- 220
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W1993889588
- Cited by
- 1,361
- References
- 10
- Citations by year
- 2026: 38 · 2025: 43 · 2024: 58 · 2023: 68 · 2022: 64 · 2021: 114 · 2020: 103 · 2019: 138 · 2018: 92 · 2017: 127 · 2016: 117 · 2015: 122 · 2014: 104 · 2013: 112 · 2012: 57
- FWCI
- 90.23
- Type
- journal article
- Language
- en
- Open access
- Licence
- other-oa
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- Research Portal (King's College London) (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- clinical high risk for psychosis, transition to psychosis, psychosis prediction, age as moderator, diagnostic criteria, longitudinal follow-up
- MeSH terms
- Adolescent, Adult, Age Factors, Humans, Psychiatric Status Rating Scales, Psychotic Disorders, Risk Factors, Disease Progression, Kaplan-Meier Estimate, Young Adult
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