Starting from the early descriptions of Kraepelin and Bleuler, the construct of schizotypy was developed from observations of aberrations in nonpsychotic family members of schizophrenia patients. In contemporary diagnostic manuals, the positive symptoms of schizotypal personality disorder were included in the ultra high-risk (UHR) criteria 20 years ago, and nowadays are broadly employed in clinical early detection of psychosis. The schizotypy construct, now dissociated from strict familial risk, also informed research on the liability to develop any psychotic disorder, and in particular schizophrenia-spectrum disorders, even outside clinical settings. Against the historical background of schizotypy it is surprising that evidence from longitudinal studies linking schizotypy, UHR, and conversion to psychosis has only recently emerged; and it still remains unclear how schizotypy may be positioned in high-risk research. Following a comprehensive literature search, we review 18 prospective studies on 15 samples examining the evidence for a link between trait schizotypy and conversion to psychosis in 4 different types of samples: general population, clinical risk samples according to UHR and/or basic symptom criteria, genetic (familial) risk, and clinical samples at-risk for a nonpsychotic schizophrenia-spectrum diagnosis. These prospective studies underline the value of schizotypy in high-risk research, but also point to the lack of evidence needed to better define the position of the construct of schizotypy within a developmental psychopathology perspective of emerging psychosis and schizophrenia-spectrum disorders.

This prognostic study evaluates whether psychosis transition can be predicted in patients with clinical high-risk syndromes or recent-onset depression by multimodal machine learning that optimally integrates clinical and neurocognitive data, structural magnetic resonance imaging, and polygenic risk scores for schizophrenia.

[Correction Notice: An Erratum for this article was reported in Vol 125(7) of (see record 2016-47529-004). In the article, there was an error in the Author Note. The affiliation of Daniela Hubl was incorrectly listed as "University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern." It should have been listed as "University Hospital of Psychiatry and Psychotherapy, University of Bern." All versions of this article have been corrected.] Schizotypy is considered an indicator of psychosis-proneness and therefore, a precursor to schizophrenia-spectrum psychosis. In the early detection of psychosis, the widely used ultra high-risk criteria refer to the positive features of schizotypy and schizotypal personality disorders (SPD). In clinical high risk (CHR) samples, self-reported or clinically assessed SPD, notably the lack of close friends, has been suggested to facilitate the prediction of psychosis. In community samples, self-reported schizotypy has mainly been assessed psychometrically using the 4 Wisconsin Schizotypy Scales (WSS; Chapman, Chapman, Kwapil, Eckbald,& Zinser, 1994), and the positive schizotypy dimension was consistently predictive of psychosis (Debbané et al., 2015). However, psychometrically assessed schizotypy has not yet been studied as a potential predictor of psychosis in CHR samples. To bridge this gap, we studied the psychosis-predictive value of 3 of the WSSs and their association with CHR state in a clinical sample. One hundred 28 patients (23 ± 7 years; 81% considered CHR) from 2 early detection services were followed for 12 to 101 months. Within 48 months, 36 (28.1%) converted to psychosis. Only physical anhedonia was associated with CHR state, and high scores for physical anhedonia were predictive of conversion in conjunction with the CHR state. Physical anhedonia rather than positive schizotypy scales might separate future converters from nonconverters in clinical samples already presenting a phenomenologically more extreme range on the psychosis continuum. Given their reported psychosis-predictive value in nonclinical samples, psychometric schizotypy measures in general might be useful for the initial screening of psychosis-proneness in the community, whereas physical anhedonia might be particularly useful in CHR samples. (PsycINFO Database Record

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