Outcomes of non_transitioned cases in a sample at ultra-high risk for psychosis: a medium to long_term follow_up study

Presentation First Author: 
Ashleigh Lin

Background: Less than a third of individuals identified as ultra-high risk (UHR) for psychosis will develop frank psychotic disorder. Little is known about the outcomes of individuals at UHR who do not develop psychosis. This study aimed to examine non-psychotic diagnoses, comorbidities and attenuated psychotic symptoms at follow-up, as well as the course of non-psychotic disorders. Method: Participants were help-seeking individuals identified as UHR for psychosis between two and 14 years previously (median=5.72). The current sample consists of 226 UHR participants (125 females; 101 males) who completed follow-up assessment and who had not developed psychosis. Mean age at follow-up was 25.5 years (SD=4.8). Results: The sample showed significant psychopathology. 28.3% of the sample reported attenuated positive psychotic symptoms at follow-up, which were associated with the presence of mood disorder. 68.1% of the sample had a non-psychotic disorder during follow- up. This included 48.7% with mood disorder, 34.5% with anxiety disorder and 29.2% with substance use disorder. Major depressive disorder, cannabis dependence, social phobia and alcohol abuse were the most prevalent diagnoses. The majority of these disorders were present at baseline, with a lower number of cases of new onset of disorder. The incidence of new disorders was 35%. Baseline symptomatology, functioning, age and gender were poor predictors of the incidence of new disorder or continuity of existing disorders. Conclusions: Non-transitioned UHR cases are at significant risk for ongoing attenuated psychotic symptoms, and persistence and some new incidence of a range of non-psychotic disorders and. The UHR phenotype, while relatively specific to incident psychosis, also captures patients with a range of emerging, persistent or recurrent non-psychotic psychopathology. Ongoing access to and tenure in clinical care is clearly justified.

Conference Name: 
Presentation Date: 
November, 2013
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