Psychosocial Outcome In Patients At Clinical High Risk Of Psychosis

Presentation First Author: 
Raimo K Salokangas

Introduction: In patients at clinical high risk (CHR) of psychosis, transition to psychosis has been the focus of several recent studies. Our aim was to study global psychosocial state and outcome in CHR patients, as well as factors associating with baseline state and short-term outcome. Methods: In the EPOS (European Prediction of Psychosis Study) project, 244 young help-seeking CHR patients were assessed with the Strauss and Carpenter Prognostic Scale (SCPS) at baseline, and 149 (61.1 %) of them were assessed for the second time at 18-month follow up. Results: Female gender, ever-married/cohabitating relationship, and good working/studying situation were associated with good baseline SCPS sum scores. During the 18-month follow-up, patients’ psychosocial state improved significantly. Less favourable SCPS score changes were associated with female gender and non-white ethnic background. One third of the CHR patients had poor global outcome. Poor working/studying situation and lower education were associated with poor global outcome. Transition to psychosis was associated with baseline SCPS scores but not with follow-up SCPS scores or with global outcome. Conclusions: The majority of the CHR patients experience good short-term recovery, but one third have poor psychosocial outcome. Good working situation is the major indicator of good outcome in CHR patients. Low education and non-white ethnicity also seem to be associated with poor outcome. Transition to psychosis has little effect on psychosocial outcome in CHR patients. In treating CHR patients, clinicians should focus their attention on a broader outcome, not only on preventing transition to psychosis.

Conference Name: 
Presentation Date: 
January, 2013
Additional Authors: 
Raimo K. R. Salokangas, Dorien H Nieman, Markus Heinimaa, Sinikka Luutonen, Heinrich Graf von Reventlow, Georg Juckel, Don Linszen, Peter Dingemans, Max Birchwood, Paul Patterson, Stephan Ruhrmann, Joachim Klosterkötter
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