PMID- 28053131
OWN - NLM
STAT- MEDLINE
DCOM- 20170724
LR  - 20231112
IS  - 1745-1701 (Electronic)
IS  - 0586-7614 (Print)
IS  - 0586-7614 (Linking)
VI  - 43
IP  - 1
DP  - 2017 Jan
TI  - A Severity-Based Clinical Staging Model for the Psychosis Prodrome: Longitudinal 
      Findings From the New York Recognition and Prevention Program.
PG  - 64-74
LID - 10.1093/schbul/sbw155 [doi]
AB  - Clinical staging improved the possibility of intervening during the psychosis 
      prodrome to limit progression of illness. The current study aimed to validate a 
      novel 4-stage severity-based model with a focus on clinical change over time and 
      risk for conversion to psychosis. One hundred seventy-one individuals at clinical 
      high risk (CHR) for psychosis were followed prospectively (3 +/- 1.6 y) as part of 
      the Recognition and Prevention (RAP) program and divided into 4 diagnostic stages 
      according to absence/presence and severity of attenuated positive symptoms. 
      Twenty-two percent of the combined sample recovered (no prodromal symptoms) by 
      study outcome. The negative symptoms only subgroup had the highest symptom 
      stability (70%), but the lowest conversion rate at 5.9%. The subgroup with more 
      severe baseline attenuated positive symptom levels had a higher conversion rate 
      (28%) and a more rapid onset when compared to the moderate attenuated positive 
      symptom subgroup (11%). Finally, the Schizophrenia-Like Psychosis (SLP) subgroup 
      showed low stability (3%), with 49% developing a specific psychotic disorder. The 
      proposed stage model provides a more finely grained classification system than 
      the standard diagnostic approach for prodromal individuals. All 4 stages are in 
      need of early intervention because of low recovery rates. The negative symptom 
      only stage is possibly a separate clinical syndrome, with an increased risk of 
      functional disability. Both subgroups with attenuated positive symptoms are 
      appropriate for studying the mechanisms of psychosis risk, however, individuals 
      with more severe baseline positive symptoms appear better suited to clinical 
      trials. Finally, the SLP category represents an intermediate outcome group 
      appropriate for preventative intervention research but questionable for inclusion 
      in prodromal studies of mechanisms.
CI  - (c) The Author 2016. Published by Oxford University Press on behalf of the Maryland 
      Psychiatric Research Center. All rights reserved. For permissions, please email: 
      journals.permissions@oup.com.
FAU - Carrion, Ricardo E
AU  - Carrion RE
FAU - Correll, Christoph U
AU  - Correll CU
FAU - Auther, Andrea M
AU  - Auther AM
AD  - Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, 
      Glen Oaks, NY.
AD  - Department of Psychiatry, Hofstra Northwell School of Medicine, Hempstead, NY.
FAU - Cornblatt, Barbara A
AU  - Cornblatt BA
LA  - eng
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Schizophr Bull
JT  - Schizophrenia bulletin
JID - 0236760
SB  - IM
MH  - Adolescent
MH  - *Disease Progression
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - *Prodromal Symptoms
MH  - Psychotic Disorders/classification/*diagnosis
MH  - Reproducibility of Results
MH  - Risk
MH  - Schizophrenia/classification/*diagnosis
MH  - *Severity of Illness Index
PMC - PMC5216868
OTO - NOTNLM
OT  - clinical high risk
OT  - clinical staging
OT  - schizophrenia
EDAT- 2017/01/06 06:00
MHDA- 2017/07/25 06:00
PMCR- 2018/01/01
CRDT- 2017/01/06 06:00
PHST- 2017/01/06 06:00 [entrez]
PHST- 2017/01/06 06:00 [pubmed]
PHST- 2017/07/25 06:00 [medline]
PHST- 2018/01/01 00:00 [pmc-release]
AID - sbw155 [pii]
AID - 10.1093/schbul/sbw155 [doi]
PST - ppublish
SO  - Schizophr Bull. 2017 Jan;43(1):64-74. doi: 10.1093/schbul/sbw155.