PMID- 21825282
OWN - NLM
STAT- MEDLINE
DCOM- 20130516
LR  - 20240418
IS  - 1745-1701 (Electronic)
IS  - 0586-7614 (Print)
IS  - 0586-7614 (Linking)
VI  - 38
IP  - 6
DP  - 2012 Nov
TI  - Recovery from an at-risk state: clinical and functional outcomes of putatively 
      prodromal youth who do not develop psychosis.
PG  - 1225-33
LID - 10.1093/schbul/sbr098 [doi]
AB  - BACKGROUND: The "clinical high risk" (CHR) construct was developed to identify 
      individuals at imminent risk of developing psychosis. However, most individuals 
      identified as CHR do not convert to psychosis, and it is unknown whether these 
      nonconverting individuals actually recover from an at-risk state. METHODS: 
      Eighty-four prospectively identified patients meeting CHR criteria, and 58 
      healthy comparison subjects were followed in a 2-year longitudinal study. 
      Analyses examined rates of conversion, clinical, and functional recovery. 
      Proportional cause-specific hazard models were used to examine the effects of 
      baseline and time-varying predictors on conversion and remission. Trajectories of 
      symptoms and psychosocial functioning measures were compared across outcome 
      groups. RESULTS: Competing risk survival analyses estimated that 30% of CHR 
      subjects convert to psychosis by 2 years, while 36% symptomatically remit and 30% 
      functionally recover by 2 years. Lower levels of negative and mood/anxiety 
      symptoms were related to increased likelihood of both symptomatic and functional 
      recovery. CHR subjects who remitted symptomatically were more similar to healthy 
      controls in terms of both their baseline and longitudinal symptoms and 
      functioning than the other outcome groups. CONCLUSIONS: Nonconverting CHR cases 
      represented a heterogeneous group. Given that nonconverted subjects who remitted 
      symptomatically also presented initially with less severe prodromal 
      symptomatology and showed a distinct normative trajectory of both symptoms and 
      psychosocial functioning over time, it may be possible to refine the CHR criteria 
      to reduce the number of "false positive" cases by eliminating those who present 
      with less severe attenuated positive symptoms or show early improvements in terms 
      of symptoms or functioning.
FAU - Schlosser, Danielle A
AU  - Schlosser DA
AD  - Department of Psychiatry, University of California, 401 Parnassus Avenue, Box 
      0984, San Francisco, CA 94143, USA. danielle.schlosser@ucsf.edu
FAU - Jacobson, Sarah
AU  - Jacobson S
FAU - Chen, Qiaolin
AU  - Chen Q
FAU - Sugar, Catherine A
AU  - Sugar CA
FAU - Niendam, Tara A
AU  - Niendam TA
FAU - Li, Gang
AU  - Li G
FAU - Bearden, Carrie E
AU  - Bearden CE
FAU - Cannon, Tyrone D
AU  - Cannon TD
LA  - eng
GR  - T32 MH082719-02/MH/NIMH NIH HHS/United States
GR  - MH65079/MH/NIMH NIH HHS/United States
GR  - T32 MH089920-02/MH/NIMH NIH HHS/United States
GR  - T32 MH089920/MH/NIMH NIH HHS/United States
GR  - P50 MH066286/MH/NIMH NIH HHS/United States
GR  - K23 MH087708/MH/NIMH NIH HHS/United States
GR  - T32 MH082719/MH/NIMH NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20110808
PL  - United States
TA  - Schizophr Bull
JT  - Schizophrenia bulletin
JID - 0236760
SB  - IM
MH  - Adolescent
MH  - Affective Symptoms/epidemiology
MH  - Anxiety/epidemiology
MH  - Case-Control Studies
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - *Prodromal Symptoms
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - Psychotic Disorders/*epidemiology
MH  - Remission, Spontaneous
MH  - Risk Factors
MH  - Time Factors
MH  - Young Adult
PMC - PMC3494042
EDAT- 2011/08/10 06:00
MHDA- 2013/05/17 06:00
PMCR- 2013/11/01
CRDT- 2011/08/10 06:00
PHST- 2011/08/10 06:00 [entrez]
PHST- 2011/08/10 06:00 [pubmed]
PHST- 2013/05/17 06:00 [medline]
PHST- 2013/11/01 00:00 [pmc-release]
AID - sbr098 [pii]
AID - 10.1093/schbul/sbr098 [doi]
PST - ppublish
SO  - Schizophr Bull. 2012 Nov;38(6):1225-33. doi: 10.1093/schbul/sbr098. Epub 2011 Aug 
      8.