Predicting Psychosis
Top Cited Papers
- 1 March 2012
- journal article
- review article
- Published by American Medical Association (AMA) in Archives of General Psychiatry
- Vol. 69 (3), 220-229
- https://doi.org/10.1001/archgenpsychiatry.2011.1472
Abstract
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.Keywords
This publication has 57 references indexed in Scilit:
- The psychosis risk syndrome and its proposed inclusion in the DSM-V: A risk–benefit analysisSchizophrenia Research, 2010
- Markers of Basal Ganglia Dysfunction and Conversion to Psychosis: Neurocognitive Deficits and Dyskinesias in the Prodromal PeriodBiological Psychiatry, 2010
- Language network dysfunction as a predictor of outcome in youth at clinical high risk for psychosisSchizophrenia Research, 2010
- Validity of the Prodromal Risk Syndrome for First Psychosis: Findings From the North American Prodrome Longitudinal StudySchizophrenia Bulletin, 2009
- Subjective Symptoms of Schizophrenia in Research and the Clinic: The Basic Symptom ConceptSchizophrenia Bulletin, 2009
- Rates of Homicide During the First Episode of Psychosis and After Treatment: A Systematic Review and Meta-analysisSchizophrenia Bulletin, 2008
- A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness–persistence–impairment model of psychotic disorderPsychological Medicine, 2008
- Basic Symptoms and Ultrahigh Risk Criteria: Symptom Development in the Initial Prodromal StateSchizophrenia Bulletin, 2008
- Three-Year Follow-up of a Randomized Controlled Trial of Cognitive Therapy for the Prevention of Psychosis in People at Ultrahigh RiskSchizophrenia Bulletin, 2007
- Quantifying heterogeneity in a meta-analysisStatistics in Medicine, 2002