Follow-up of subjects with suspected pre-psychotic state in Taiwan
Journal
Schizophrenia Research
Journal Volume
126
Journal Volume
126
Journal Issue
1-3
Journal Issue
1-3
Pages
65-70
Start Page
65
End Page
70
ISSN
0920-9964
Date Issued
2011-03
Author(s)
MENG-CHUAN LAI
MAU-SUN HUA
YA-CHUAN HUANG
Abstract
Objective: To describe the outcomes of subjects with suspected pre-psychotic state in Taiwan. Methods: A prospective clinical observation was performed on subjects recruited by referrals from a community-based population. Three pre-psychotic risk groups were established by means of clinical interviews: an ultra-high risk group (UHR; 59 subjects), an intermediate-risk group (IRG; 46 subjects), and a marginal-risk group (MRG; 48 subjects). Also recruited were 60 subjects with first-episode psychosis (FEP) and 144 normal controls (NC group). All subjects were aged 16 to 32. years. Results: Of the 59 UHR subjects, 21 (35.6%) converted to FEP, including 15 with schizophrenia (6 had relatively brief positive yet persistent prominent negative symptoms), 2 with schizophreniform disorder, 1 with schizoaffective disorder, 2 with brief psychotic disorder, and 1 with bipolar disorder. The cumulative ± SE rate of conversion to psychosis was 21.7% ± 5.4% at 6. months, 28.2% ± 6.2% at 12. months, 30.4% ± 6.4% at 18. months, and 33.3% ± 6.8% at 24. months. The UHR subjects who converted had a higher rate of initial antipsychotic use than those who did not convert. Only half of the IRG and two-thirds of the MRG subjects received follow-up, and none of them developed FEP. Conclusions: Our results lent support to both sides of the current debate regarding establishing a new diagnostic category of "psychosis risk syndrome." The divergent trajectories of the UHR subjects deserve more clinical attention, especially with regard to the use of antipsychotics and the presence of a group with prominent negative symptoms. ? 2010 Elsevier B.V.
SDGs
Other Subjects
neuroleptic agent; adolescent; adult; article; bipolar disorder; brief psychotic disorder; clinical observation; community; controlled study; disease duration; drug withdrawal; female; follow up; high risk population; human; interview; low drug dose; major clinical study; male; outcome assessment; patient referral; priority journal; psychosis; schizoaffective psychosis; schizophrenia; schizophreniform disorder; symptomatology; Taiwan; Adolescent; Adult; Female; Humans; Longitudinal Studies; Male; Psychotic Disorders; Residence Characteristics; Survival Analysis; Taiwan; Young Adult
Type
journal article