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Clinical Distress, Prodrome, Psychosis, Ultra-High-Risk


This is the pre-peer reviewed version of the following article: Early Intervtion Psychiatry. 2015 Mar 15. doi: 10.1111/eip.12233. [Epub ahead of print], which has been published in final form at doi: 10.1111/eip.12233.This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.


AIM: The 'ultra-high-risk' criteria identify a clinical population at substantially increased risk for progressing to schizophrenia and other psychotic disorders. Although a number of clinical variables predictive of transition to psychotic disorder have been identified within this population, the predictive value of the level of distress associated with attenuated psychotic symptoms has not yet been examined. This was the aim of the present study.

METHOD: The level of distress (0-100) associated with attenuated psychotic symptoms was recorded for 70 ultra-high-risk (UHR) patients using the Comprehensive Assessment of At-Risk Mental State (CAARMS). Transition to psychosis was assessed over a 16-month follow-up period.

RESULTS: Of the 70 UHR patients, 15 transitioned to psychosis (21.4%). Of the four CAARMS subscales measuring attenuated positive symptoms, Perceptual Abnormalities was rated as the most distressing. There were no differences in CAARMS scales rated as the most distressing between those who transitioned to psychosis and those who did not. There was also no association between higher levels of distress associated with attenuated psychotic symptoms and transition to psychosis.

CONCLUSION: Although the findings require replication, they indicate that the degree of distress associated with attenuated psychotic symptoms should not be used as a criterion for enriching UHR samples for risk of frank psychotic disorder.


Medicine and Health Sciences | Psychiatry and Psychology


Power L, Polari AR, Yung AR, McGorry PD, Nelson B. Distress in relation to attenuated psychotic symptoms in the ultra-high-risk population is not associated with increased risk of psychotic disorder. Early Intervention Psychiatry. 2015 Mar 15. [Epub ahead of print]

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