PMID- 25012147 OWN - NLM STAT- MEDLINE DCOM- 20150526 LR - 20211021 IS - 1573-2509 (Electronic) IS - 0920-9964 (Print) IS - 0920-9964 (Linking) VI - 158 IP - 1-3 DP - 2014 Sep TI - Current status specifiers for patients at clinical high risk for psychosis. PG - 69-75 LID - S0920-9964(14)00314-4 [pii] LID - 10.1016/j.schres.2014.06.022 [doi] AB - 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. CI - Copyright (c) 2014. Published by Elsevier B.V. FAU - Woods, Scott W AU - Woods SW AD - Department of Psychiatry, Yale University, New Haven, CT, United States. Electronic address: scott.woods@yale.edu. FAU - Walsh, Barbara C AU - Walsh BC AD - Department of Psychiatry, Yale University, New Haven, CT, United States. FAU - Addington, Jean AU - Addington J AD - Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada. FAU - Cadenhead, Kristin S AU - Cadenhead KS AD - Department of Psychiatry, UCSD, San Diego, CA, United States. FAU - Cannon, Tyrone D AU - Cannon TD AD - Department of Psychology, Yale University, New Haven, CT, United States. FAU - Cornblatt, Barbara A AU - Cornblatt BA AD - Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, United States. FAU - Heinssen, Robert AU - Heinssen R AD - Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, MD, United States. FAU - Perkins, Diana O AU - Perkins DO AD - Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States. FAU - Seidman, Larry J AU - Seidman LJ AD - Department of Psychiatry, Harvard Medical School, Boston, MA, United States. FAU - Tarbox, Sarah I AU - Tarbox SI AD - Department of Psychiatry, Yale University, New Haven, CT, United States. FAU - Tsuang, Ming T AU - Tsuang MT AD - Department of Psychiatry, UCSD, San Diego, CA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States. FAU - Walker, Elaine F AU - Walker EF AD - Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, United States. FAU - McGlashan, Thomas H AU - McGlashan TH AD - Department of Psychiatry, Yale University, New Haven, CT, United States. LA - eng GR - U01 MH065079/MH/NIMH NIH HHS/United States GR - U01 MH081988/MH/NIMH NIH HHS/United States GR - U01MH066160/MH/NIMH NIH HHS/United States GR - U01 MH065562/MH/NIMH NIH HHS/United States GR - U01MH081984/MH/NIMH NIH HHS/United States GR - MH081902/MH/NIMH NIH HHS/United States GR - K24 MH76191/MH/NIMH NIH HHS/United States GR - R01 MH065079/MH/NIMH NIH HHS/United States GR - U01 MH082022/MH/NIMH NIH HHS/United States GR - U01 MH081984/MH/NIMH NIH HHS/United States GR - R01 MH60720/MH/NIMH NIH HHS/United States GR - R01 MH061523/MH/NIMH NIH HHS/United States GR - U01 MH061523/MH/NIMH NIH HHS/United States GR - U01 MH081902/MH/NIMH NIH HHS/United States GR - U01 MH060720/MH/NIMH NIH HHS/United States GR - P50 MH080272/MH/NIMH NIH HHS/United States GR - U01 MH062066/MH/NIMH NIH HHS/United States GR - K23 MH001905/MH/NIMH NIH HHS/United States GR - U01 MH066069/MH/NIMH NIH HHS/United States GR - R01 MH062066/MH/NIMH NIH HHS/United States GR - R01 MH065562/MH/NIMH NIH HHS/United States GR - U01 MH066160/MH/NIMH NIH HHS/United States GR - K24 MH076191/MH/NIMH NIH HHS/United States GR - P50MH080272/MH/NIMH NIH HHS/United States GR - U01 MH066134/MH/NIMH NIH HHS/United States GR - R01 MH060720/MH/NIMH NIH HHS/United States GR - U01 MH081928/MH/NIMH NIH HHS/United States GR - U01 MH081857/MH/NIMH NIH HHS/United States GR - U01 MH082004/MH/NIMH NIH HHS/United States GR - U01 MH081944/MH/NIMH NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PT - Validation Study DEP - 20140708 PL - Netherlands TA - Schizophr Res JT - Schizophrenia research JID - 8804207 SB - IM MH - Disease Progression MH - Humans MH - *Interview, Psychological MH - Longitudinal Studies MH - Psychotic Disorders/*classification/diagnosis/therapy MH - Risk PMC - PMC4152558 MID - NIHMS612662 OTO - NOTNLM OT - Clinical high risk OT - Course of illness OT - Current status OT - Psychosis OT - Risk syndrome COIS- Conflict of interest Dr. Woods reports that within three years of beginning this work he has received investigator-initiated research funding support from UCB Pharma, Eli Lilly, Janssen, Pfizer, and Bristol-Myers Squibb and has consulted to Otsuka and Schering-Plough. He has also served as an unpaid consultant to DSM-5. Drs. Walsh, Addington, Cadenhead, Seidman, Tarbox, Tsuang, and Walker report no actual or potential conflict of interest. Dr. Cannon reports that within three years of beginning this work he has served as a consultant for Janssen Pharmaceuticals and Eli Lilly. Dr. Cornblatt reports that within three years of beginning this work she has served as a consultant for Lilly, Bristol-Meyers Squibb and Janssen Pharmaceuticals and has received unrestricted educational grants from Janssen. Dr. Heinssen is an employee of the US National Institutes of Health. Dr. Perkins reports that within three years of beginning this work she has received research funding from AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb, Otsuka Pharmaceutical Co. Ltd, Eli Lilly and Co., Janssen Pharmaceutica Products, and Pfizer Inc.; and consulting and educational fees from AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb, Eli Lilly and Co., Janssen Pharmaceuticals, GlaxoSmithKline, Forest Labs, Pfizer Inc, and Shire. Dr. McGlashan reports that within three years of beginning this work he has received investigator-initiated research funding support from Eli Lilly Company. He has also served as a consultant for Lilly, Pfizer, Solvay/Wyeth, and Roche pharmaceuticals and as an unpaid consultant to DSM-5. EDAT- 2014/07/12 06:00 MHDA- 2015/05/27 06:00 PMCR- 2015/09/01 CRDT- 2014/07/12 06:00 PHST- 2014/03/31 00:00 [received] PHST- 2014/06/02 00:00 [revised] PHST- 2014/06/08 00:00 [accepted] PHST- 2014/07/12 06:00 [entrez] PHST- 2014/07/12 06:00 [pubmed] PHST- 2015/05/27 06:00 [medline] PHST- 2015/09/01 00:00 [pmc-release] AID - S0920-9964(14)00314-4 [pii] AID - 10.1016/j.schres.2014.06.022 [doi] PST - ppublish SO - Schizophr Res. 2014 Sep;158(1-3):69-75. doi: 10.1016/j.schres.2014.06.022. Epub 2014 Jul 8.