Current status specifiers for patients at clinical high risk for psychosis

SCHIZOPHRENIA RESEARCH

卷:158

Article

Woods, Scott W.¹  Walsh, Barbara C.¹  Addington, Jean²  Cadenhead, Kristin S.³  Cannon, Tyrone D.⁴  Cornblatt, Barbara A.⁵  Heinssen, Robert⁶  Perkins, Diana O.⁷  Seidman, Larry J.⁸  Tarbox, Sarah I.¹  Tsuang, Ming T.^3,8  Walker, Elaine F.^9,10  McGlashan, Thomas H.¹ 

[1] Yale Univ, Dept Psychiat, New Haven, CT 06519 USA

[2] Univ Calgary, Dept Psychiat, Calgary, AB, Canada

[3] Univ Calif San Diego, Dept Psychiat, San Diego, CA USA

[4] Yale Univ, Dept Psychol, New Haven, CT 06519 USA

[5] Zucker Hillside Hosp, Dept Psychiat, Long Isl City, NY USA

[6] NIMH, Div Serv & Intervent Res, Bethesda, MD 20892 USA

[7] Univ N Carolina, Dept Psychiat, Chapel Hill, NC USA

[8] Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA

[9] Emory Univ, Dept Psychol, Atlanta, GA 30322 USA

[10] Emory Univ, Dept Psychiat, Atlanta, GA 30322 USA

关键词: Psychosis;    Clinical high risk;    Risk syndrome;    Current status;    Course of illness;   

DOI  :  10.1016/j.schres.2014.06.022

来源: Elsevier

【 摘 要 】

Background: Longitudinal studies of the clinical high risk (CHR) syndrome for psychosis have emphasized the conversion vs non-conversion distinction and thus far have not focused intensively on classification among non-converters. The present study proposes a system for classifying CHR outcomes over time when using the Structured Interview for Psychosis-risk Syndromes and evaluates its validity. Method: The system for classifying CHR outcomes is referred to as current status specifiers, with current meaning over the month prior to the present evaluation and specifiers indicating a set of labels and descriptions of the statuses. Specifiers for four current statuses are described: progression, persistence, partial remission, and full remission. Data from the North American Prodromal Longitudinal Study were employed to test convergent, discriminant, and predictive validity of the current status distinctions. Results: Validity analyses partly supported current status distinctions. Social and role functioning were more impaired in progressive and persistent than in remitted patients, suggesting a degree of convergent validity. Agreement between CHR current statuses and current statuses for a different diagnostic construct (DSM-IV Major Depression) was poor, suggesting discriminant validity. The proportion converting to psychosis within a year was significantly higher in cases meeting progression criteria than in those meeting persistence criteria and tended to be higher than in those meeting full remission criteria, consistent with a degree of predictive validity. Discussion: CHR syndrome current status specifiers could offer a potentially valid and useful description of current clinical status among non-converters. Study in additional samples is needed. (C) 2014 Published by Elsevier B.V.

【 授权许可】

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