Prospective Study of Adolescents with Subsyndromal Psychosis: Characteristics and Outcome

Abstract

This study indicates that psychotic symptoms not fulfilling criteria for schizophrenia or a psychotic mood disorder are unreliable predictors of a syndromal psychotic disorder outcome at 2 years. Long-term studies of PsyNOS and BrPsy are needed to clarify where these disorders fall in the developmental course of schizophrenia.

The ‘At-Risk Mental State’ for Psychosis in Adolescents: Clinical Presentation, Transition and Remission

“…In line with previous findings, co-morbidity at presentation to services was the norm, with depression and anxiety disorders frequently observed [24,26,35,36,27]. Interestingly, individuals with co-morbid depression experienced more perceptual disturbances and unusual thought content, suggesting the existence of a sub-group of ARMS individuals.…”

“…Only a handful of studies have looked at the presentation of at-risk adolescents [35][36][37][38] excluding studies where risk is solely based on genetic predisposition. In one of the first studies, Meyer and colleagues [36] identified 24 adolescents who reported significant perceptual abnormalities (20/24, 83%), unusual thought content (18/24, 75%) and suspiciousness (13/54%) symptoms at baseline assessment.…”

14:15 Persistence of the Extended Psychosis Phenotype in Young People: Link Between Vulnerability and Clinical Need

“…There are multiple developmental paths that may eventually end in psychosis; likewise, subclinical psychotic experiences may lead to very heterogeneous outcomes (Keshavan, DeLisi, & Seidman, 2011). Earlier studies have suggested that cross sectional measurements of subclinical psychotic experiences may not be particularly useful as a specific risk factor for later clinical psychotic outcomes (Correll et al, 2005), in part because such experiences are so common ) and dynamic ). Furthermore, results are inconsistent in regard to whether Introduction risk factors associated with development of psychosis are not specific for psychosis, but are predictive of more general later psychopathology (Breetvelt et al, 2010;Laurens et al, 2007).…”

“…Earlier studies have suggested that cross sectional measurements of subclinical psychotic experiences may not be useful as a specific risk factor for later clinical psychotic outcomes (Correll et al, 2005), in part because they are so common ).…”

Progress in the prospective study of the schizophrenia prodrome

“…None in the group with atypical psychosis developed frank psychosis after 2 years of follow-up, but were reported to be more likely to have comorbid posttraumatic stress disorder or depression. Another study by Correll et al [15] followed adolescents with psychosis not otherwise specified or brief psychotic disorder (both including symptoms at a psychotic level of severity, but not meeting criteria for schizophrenia) for up to 2 years, and only a fraction (7/26, or 27%) developed schizophrenia or schizoaffective disorder, and only two had the same initial diagnosis at follow-up. The studies by Correll et al and Hlastala et al in addition to the growing prospective prodromal schizophrenia literature suggest that even symptoms at a psychotic level of severity show relatively poor predictive value for schizophrenia leading to the potential inaccurate identification of individuals as prodromal or at-risk.…”