Journal Article

Neurocognitive and Clinical Predictors of Long-Term Outcome in Adolescents at Ultra-High Risk for Psychosis: A 6-Year Follow-Up

Wit, Sanne de, Schothorst, Patricia, Durston, Sarah, Sprong, Mirjam, Engeland, Herman van, Kahn, René, Ziermans, Tim

2014

Overview

Most studies aiming to predict transition to psychosis for individuals at ultra-high risk (UHR) have focused on either neurocognitive or clinical variables and have made little effort to combine the two. Furthermore, most have focused on a dichotomous measure of transition to psychosis rather than a continuous measure of functional outcome. We aimed to investigate the relative value of neurocognitive and clinical variables for predicting both transition to psychosis and functional outcome. Forty-three UHR individuals and 47 controls completed an extensive clinical and neurocognitive assessment at baseline and participated in long-term follow-up approximately six years later. UHR adolescents who had converted to psychosis (UHR-P; n = 10) were compared to individuals who had not (UHR-NP; n = 33) and controls on clinical and neurocognitive variables. Regression analyses were performed to determine which baseline measures best predicted transition to psychosis and long-term functional outcome for UHR individuals. Low IQ was the single neurocognitive parameter that discriminated UHR-P individuals from UHR-NP individuals and controls. The severity of attenuated positive symptoms was the only significant predictor of a transition to psychosis and disorganized symptoms were highly predictive of functional outcome. Clinical measures are currently the most important vulnerability markers for long-term outcome in adolescents at imminent risk of psychosis.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adolescent / Adolescents / Archives & records / Biology and Life Sciences / Care and treatment / Case-Control Studies / Child & adolescent psychiatry / Cognition / Consent / Continuity (mathematics) / Diagnosis / Families & family life / Female / Follow-Up Studies / Humans / Male / Mathematical analysis / Medicine and Health Sciences / Mental disorders / Models, Psychological / Neuropsychological Tests / Neurosciences / Patient Outcome Assessment / Prognosis / Psychiatric Status Rating Scales / Psychological aspects / Psychoses / Psychosis / Psychotic Disorders - diagnosis / Psychotic Disorders - psychology / Regression analysis / Research and Analysis Methods / Risk / Risk factors / ROC Curve / Schizophrenia / Social Sciences / Studies / Teenagers / Young adults / Youth