Universität zu Köln

Michel, Chantal ORCID: 0000-0003-1165-6681, Ruhrmann, Stephan ORCID: 0000-0002-6022-2364, Schimmelmann, Benno G., Klosterkoetter, Joachim and Schultze-Lutter, Frauke (2018). Course of clinical high-risk states for psychosis beyond conversion. Eur. Arch. Psych. Clin. Neurosci., 268 (1). S. 39 - 49. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-8491

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Abstract

The main focus of research on clinical high-risk states for psychosis (CHR) has been the development of algorithms to predict psychosis. Consequently, other outcomes have been neglected, and little is known about the long-term diagnostic and functional outcome among those not converting to psychosis. In a naturalistic study, incidence, persistence, and remission rates of CHR states according to symptomatic ultra-high risk or cognitive disturbances criteria were investigated in 160 of 246 outpatients of an early detection of psychoses service (21.1% CHR negative and 78.9% CHR positive at baseline) who had not converted to psychosis within follow-up (median 53.7 months, range 13.9-123.7 months). Remission rate of CHR status was 43.3% of all 194 CHR-positive cases, including converters, or 72.4% if only the 116 non-converters were considered, persistence rate was 27.6%, and new occurrence rate in initially CHR-negative patients was 9.1%. At follow-up, 54.5% of the non-converters met criteria of at least one Axis-I diagnosis, mainly affective and anxiety disorders, and had functional problems. The severity of risk at baseline was not associated with a higher presence of Axis-I diagnosis at follow-up. During follow-up, CHR symptoms remitted in one-third of initially CHR-positive patients, while almost 10% met CHR criteria newly in CHR-negative adults presenting at early detection services. The presence of CHR criteria seems to maintain the risk for lower functioning and mental disorders, particularly for affective disorders. Thus, therapeutic efforts targeting CHR patients should also focus on the current mental disorders as well as social and role functions to improve the long-term outcome.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Michel, Chantal UNSPECIFIED orcid.org/0000-0003-1165-6681 UNSPECIFIED Ruhrmann, Stephan UNSPECIFIED orcid.org/0000-0002-6022-2364 UNSPECIFIED Schimmelmann, Benno G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Klosterkoetter, Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Schultze-Lutter, Frauke UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-198182
DOI:	10.1007/s00406-016-0764-8
Journal or Publication Title:	Eur. Arch. Psych. Clin. Neurosci.
Volume:	268
Number:	1
Page Range:	S. 39 - 49
Date:	2018
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-8491
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ULTRA-HIGH RISK; FOLLOW-UP; YOUNG-PEOPLE; PREDICTION; SCHIZOPHRENIA; ADOLESCENTS; TRANSITION; INDIVIDUALS; REMISSION; SYMPTOMS Multiple languages Clinical Neurology; Psychiatry Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19818