Duration of attenuated positive and negative symptoms in individuals at clinical high risk: Associations with risk of conversion to psychosis and functional outcome
Section snippets
Participants
The Recognition and Prevention (RAP) program is an ongoing longitudinal study of treatment-seeking adolescents and young adults considered to be at CHR for psychosis initiated in 1998 and funded by the National Institute of Mental Health in 2000. This article reports data for participants recruited during Phase 1 (2000–2006) of the study. Patient referrals were made to the RAP Program by affiliated outpatient and inpatient psychiatry departments, local mental health providers, school
Results
CHR+ subjects had a mean age of 16.0 ± 2.2 years and were mostly male (68.4%) and white (78.9%) (see Table 1). In terms of symptoms, suspiciousness was the most prevalent positive symptom (68.4%) rated at a moderate intensity or above (≥3 on the SOPS) at baseline, while grandiosity (6.6%) was the lowest reported symptom. Within the negative symptom dimension, Decline in Occupational/Academic Functioning (77.6%), Social Anhedonia (59.2%), and Avolition (46.1%) were most prevalent at baseline
Discussion
To the best of our knowledge, this is the first study to report on the pre-baseline duration of attenuated positive symptoms and negative symptoms in CHR individuals and their relationships with symptom severity and outcome. The current study did not artificially and arbitrarily restrict the duration of onset or worsening of attenuated positive symptoms to the past 12 months prior to baseline, allowing us to compare the duration of attenuated positive and negative symptoms and to examine if, in
Conflicts of interest
Drs. Carrión, Auther, Lencz, and Ms. McLaughlin, Olsen, and Demmin report no financial relationships with commercial interests. Dr. Cornblatt has been an advisor for Hoffmann-La Roche.
Dr. Correll has been a consultant and/or advisor to or has received honoraria from AbbVie, Acadia, Actavis, Alkermes, Eli Lilly, Genentech, Gerson Lehrman Group, IntraCellular Therapies, Janssen/J&J, Lundbeck, MedAvante, Medscape, Otsuka, Pfizer, ProPhase, Reviva, Roche, Sunovion, Supernus, and Takeda. He has
Contributors
BC developed and oversaw the research protocol. RO and AA contributed to participant recruitment. AA, DM, and TL conducted clinical assessments. CC oversaw treatment decisions. DD collected data. RC and DD performed the literature review. RC and DD performed statistical analysis. All authors contributed to and approved the final manuscript.
Funding
Supported by grants from the National Institute of Mental Health (NIMH): MH61523 (Dr. Cornblatt), the Zucker Hillside Hospital Advanced Center for Intervention and Services Research for the Study of Schizophrenia MH 074543 (John M Kane, M.D.). No funding source exerted any editorial direction or censorship on any part of this manuscript.
Acknowledgments
We thank the study participants and entire staff of the RAP Program for their time and effort from the very onset of these studies.
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