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Randomized Controlled Trial
. 2021 Feb;15(1):104-112.
doi: 10.1111/eip.12917. Epub 2020 Jan 7.

Predictors of remission from the ultra-high risk state for psychosis

Louise B Glenthøj  1   2 , Tina D Kristensen  1   2 , Christina Wenneberg  1   2 , Carsten Hjorthøj  1   3 , Merete Nordentoft  1   2
Affiliations
Randomized Controlled Trial

Predictors of remission from the ultra-high risk state for psychosis

Louise B Glenthøj et al. Early Interv Psychiatry. 2021 Feb.

Abstract

Aim: A significant proportion of individuals at Ultra-High Risk (UHR) for psychosis do not transition to manifest psychosis. Many non-transitioning UHR individuals do, however, display poor long-term outcomes such as persistence of attenuated psychotic symptoms. Evidence is scarce on which variables may predict a better clinical and functional prognosis such as remission from the UHR state.

Methods: A total of 146 UHR individuals were enrolled in a randomized clinical trial (RCT), with this being analyses secondary to the RCT. Participants were assessed on multiple domains of symptoms, functioning, neuro- and social cognition. Regression analyses elucidated on the predictive power of these measures to remission from the UHR status (ie, not meeting UHR criteria) at 12-month follow-up.

Results: Of the 91 UHR individuals attending 12-month follow-up, 33 (36%) exhibited remission from the UHR state. Regression analyses revealed baseline functioning to be a significant predictor of risk remission, and this was maintained when controlling for the effect of antipsychotic medication, gender and estimated IQ. The individuals with remission from the UHR state showed lower attenuated psychotic- and depressive symptoms along with better functioning at 12-month follow-up.

Conclusion: Our findings indicate functioning to be a contributor to the symptomatic recovery of UHR individuals, but a large amount of the variance on risk remission is, however, explained by other factors. Additionally, our findings suggest that UHR individuals with better functioning at ascertainment may present with a better clinical and functional prognosis, which may inform on the need for monitoring and intervention in this subgroup.

Keywords: prodromal psychosis; recovery; remission; ultra-high risk.

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References

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