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Risk factors for psychosis in an ultra high-risk group: psychopathology and clinical features
Open accessAbstract
The identification of individuals at high risk of developing a psychotic disorder has long been a goal of clinicians because it is thought that early treatment of this group may prevent onset of the disorder. However, little is known of predictive factors of psychosis, even within a high-risk group. This study followed up 104 young people thought to be at 'ultra high risk' for schizophrenia and other psychotic disorders by virtue of having a family history of psychotic disorder combined with some functional decline or the presence of subthreshold or self-limiting psychotic symptoms. All subjects were therefore symptomatic, but not psychotic, at intake. Thirty-six subjects (34.6%) developed frank psychotic symptoms within 12 months. Measures of symptom duration, functioning, disability and psychopathology were made at intake, 6 and 12 months. Poor functioning, long duration of symptoms, high levels of depression and reduced attention were all predictors of psychosis. A combination of family history of psychosis, a recent significant decrease in functioning and recent experience of subthreshold psychotic symptoms was also predictive of psychosis. Combining highly predictive variables yielded a method of psychosis prediction at 12 months with good positive predictive value (80.8%), negative predictive value (81.8%) and specificity (92.6%) and moderate sensitivity (60.0%). Within our symptomatic high-risk group, therefore, it appears possible to identify those individuals who are at particularly high risk of developing a psychotic disorder such as schizophrenia. Given the very high PPV and low false positive rate with this two-step process, it may be justifiable to target these individuals for intensive monitoring of mental state and even low-dose neuroleptic medication or other biological and psychosocial treatments depending on clinical condition. This indicated prevention approach could be further developed and preventive strategies in the psychoses refined.
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Self-citation
Metadata
- Authors
- Yung, A. R., Phillips, L. J., Yuen, H. P., & McGorry, P. D.
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2004-04
- Volume
- 67
- Issue
- 2-3
- Pages
- 131-142
- ISSN
- 0920-9964 (ISSN-L)
- OpenAlex
- W1986504292
- Cited by
- 763
- References
- 13
- FWCI
- 12.46
- Type
- journal article
- Language
- en
- Open access
- green
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