Long-term Follow-up of a Group at Ultra High Risk (“Prodromal”) for Psychosis

作者：Barnaby Nelson, Hok Pan Yuen, Stephen J. Wood, Ashleigh Lin, Daniela Spiliotacopoulos, Annie Bruxner, Christina Broussard, Magenta Simmons, Debra L. Foley, Warrick J. Brewer, Shona M. Francey, G. Paul Amminger, Andrew Thompson, Patrick D. McGorry, Alison R. Yung · 发表于：JAMA Psychiatry · 年份：2013 · DOI：10.1001/jamapsychiatry.2013.1270 · 被引用次数：433 · 研究领域：Schizophrenia research and treatment、Treatment of Major Depression、Bipolar Disorder and Treatment

IMPORTANCE: The ultra high-risk (UHR) criteria were introduced to prospectively identify patients at high risk of psychotic disorder. Although the short-term outcome of UHR patients has been well researched, the long-term outcome is not known. OBJECTIVE: To assess the rate and baseline predictors of transition to psychotic disorder in UHR patients up to 15 years after study entry. DESIGN: Follow-up study of a cohort of UHR patients recruited to participate in research studies between 1993 and 2006. SETTING: The Personal Assessment and Crisis Evaluation (PACE) clinic, a specialized service for UHR patients in Melbourne, Australia. PARTICIPANTS: Four hundred sixteen UHR patients previously seen at the PACE clinic. MAIN OUTCOMES AND MEASURES: Transition to psychotic disorder, as measured using the Comprehensive Assessment of At-Risk Mental States, Brief Psychiatric Rating Scale/Comprehensive Assessment of Symptoms and History, or state public mental health records. RESULTS: During the time to follow-up (2.4-14.9 years after presentation), 114 of the 416 participants were known to have developed a psychotic disorder. The highest risk for transition was within the first 2 years of entry into the service, but individuals continued to be at risk up to 10 years after initial referral. The overall rate of transition was estimated to be 34.9% over a 10-year period (95% CI, 28.7%-40.6%). Factors associated with transition included year of entry into the clinic, duration of symptoms befo...