Skip to main content Accessibility help
×
Home

Prediction of psychosis: A step towards indicated prevention of schizophrenia

  • Alison R. Yung (a1), Lisa J. Phillips (a2), Patrick D. McGorry (a1), Colleen A. McFarlane (a2), Shona Francey (a3), Susan Harrigan (a4), George C. Patton (a5) and Henry J. Jackson (a3)...

Abstract

Background The identification of people at high risk of becoming psychotic within the near future creates opportunities for early intervention prior to the onset of psychosis to prevent or minimise later ill-health. The present study combines current knowledge about risk factors for schizophrenia with our knowledge of psychotic prodromes in an attempt to identify a group particularly vulnerable to impending psychosis. We wanted to identify people with high likelihood of transition to psychosis within a follow-up period of 12 months, and to determine the rate of transition to psychosis in this group.

Method Various state and trait risk factors for psychosis were used alone and in combination to operationally define a putatively high-risk group. Operationalised criteria for onset of psychosis were established. The individuals were assessed monthly on measures of psychopathology for six months.

Results Eight out of 20 people made the transition to frank psychosis within a six-month follow-up period. Follow-up of this group is still in progress, and the 12 month transition rate might prove to be higher still.

Conclusions We have demonstrated that it is possible to identify individuals with a high likelihood of onset of psychosis within a brief follow-up period. This lays the foundation for early treatment in an attempt to prevent, delay or minimise the severity of first onset of schizophrenia.

Copyright

Corresponding author

Correspondence: A. R. Yung, Centre for Young People's Mental Health, 35 Polar Road, Parkville, Victoria 3052, Australia

References

Hide All
Allen, J. J., Chapman, L. J., Chapman, J. P., et al (1987) Prediction of psychotic-like symptoms in hypothetically psychosis-prone college students. Journal of Abnormal Psychology, 96, 8388.
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.
Andreasen, N. (1982) Negative symptoms in schizophrenia. Definitions and reliability. Archives of General Psychiatry, 39, 784788.
Andreasen, N. (1987) The Comprehensive Assessment of Symptoms and History (CASH) Interview. Iowa City, IA: University of Iowa. Asarnow, J. R. (1988) Children at risk for schizophrenia: converging lines of evidence. Schizophrenia Bulletin, 14, 613631.
Beiser, M., Erickson, D., Fleming, J. A., et al (1993) Establishing the onset of psychotic illness. American Journal of Psychiatry, 150, 13491354.
Bell, R. Q. (1992) Multiple-risk cohorts and segmenting risk as solutions to the problem of false positives in risk for the major psychoses. Psychiatry, 55, 370381.
Bleuler, E. (1911) Dementia Praecox or the Group of Schizophrenias. New York: International Universities Press.
Cameron, D. E. (1938) Early schizophrenia. American Journal of Psychiatry 95, 567578.
Chapman, J. (1966) The early symptoms of schizophrenia. British Journal of Psychiatry, 112, 225251.
Chapman, L. J. & Chapman, J. P. (1980) Scales for rating psychotic and psychotic-like experiences as continua. Schizophrenia bulletin, 6, 476489.
Chapman, L. J. & Chapman, J. P. (1987) The search for symptoms predictive of schizophrenia. Schizophrenia Bulletin, 13, 497503.
Chapman, L. J., Chapman, J. P., R., Kwapil. T., et al (1994) Putatively psychosis-prone subjects 10 years later. Journal of Abnormal Psychology, 103, 171183.
Claridge, G. (1987) The schizophrenias as nervous types revisited. British Journal of Psychiatry, 151, 735743.
Eaton, W.W., Badawi, M. & Melton, B. (1995) Prodromes and precursors: epidemiologic data for primary prevention of disorders with slow onset. American Journal of Psychiatry, 152, 967972.
Erlenmeyer-Kimling, L., Cornblatt, B., Rock, D., et al (1993) The New York High Risk Project: Anhedonia, attentional deviance and psychopathology. Schizophrenia Bulletin, 19, 141153.
Faergman, P. (1963) Psychogenic Psychoses. London: Butterworths.
Falloon, I. R. H. (1992) Early intervention for first episodes of schizophrenia: a preliminary exploration. Psychiatry, 55, 415.
Gottesman, I. I. & Shields, J. (1982) Schizophrenia: the Epigenetic Puzzle. Cambridge: Cambridge University Press.
Hafner, H., Maurer, K., Loffler, W., et al (1993) The influence of age and sex on the onset and early course of schizophrenia. British Journal of Psychiatry, 162, 8086.
Hamilton, M. (I960) A rating scale for depression. Journal of Neurology Neurosurgery and Psychiatry, 23, 5662.
Heinrichs, D., Hanlon, T. & Carpenter, W. (1984) The Quality of Life Scale: An instrument for rating the schizophrenia deficit syndrome. Schizophrenia Bulletin, 10, 388398.
Jauch, D. A. & Carpenter, W.T. (1988) Reactive psychosis, I: does the DSM–III concept define a third psychosis? Journal of Nervous and Mental Disease, 176, 7281.
Kety, S. S., Rosenthal, D., Wender, P. H., et al (1975) Mental illness in the biological and adoptive families of adoptive individuals who have become schizophrenic: a preliminary report based on psychiatric interviews. In: Genetic Research in Psychiatry (eds Rieve, R. R., Rosenthal, D. & Brill, H.), pp. 147165. Baltimore: Johns Hopkins University Press.
Larsen, T. K., McGlashan, T. H. & Moe, L. C. (1996) First-episode schizophrenia: I. Early course parameters. Schizophrenia Bulletin, 22, 241256.
Loebel, A. D., Lieberman, J. A., Alvir, J. M. J., et al (1992) Duration of psychosis and outcome in first-episode schizophrenia. American Journal of Psychiatry, 149, 11831188.
Lukoff, D., Nuechterlein, K. H., et al (1986) Manual for the Expanded Brief Psychiatric Rating Scale. Schizophrenia Bulletin, 12, 594602.
McGlashan, T. H. & Johannessen, J. O. (1996) Early detection and intervention with schizophrenia: rationale. Schizophrenia Bulletin, 22, 201222.
McGorry, P. D. & Singh, B. S. (1995) Schizophrenia: risk and possibility. In: Handbook of Preventive Psychiatry (eds Raphael, B. & Burrows, G. D.), pp. 492514. Amsterdam: Elsevier.
McGorry, P. D., Edwards, J., Mihalopoulos, C., et al (1996) EPPIC: An evolving system of early detection and optimal management. Schizophrenia Bulletin, 22, 305326.
Meares, A. (1959) The diagnosis of prepsychotic schizophrenia. Lancet, i, 5559.
Mednick, S. A., Parnas, J. & Schulsinger, F. (1987) The Copenhagen High-Risk Project, 1962–1986. Schizophrenia Bulletin, 13, 485496.
Meehl, P. E. (1989) Schizotaxia revisited. Archives of General Psychiatry, 46, 935944.
Moscarelli, M. (1994) Health and economic evaluation in schizophrenia: implications for health policies. Acta Psychiotrica Scandinavica, 89 (suppl. 382), 8493.
Mrazek, P. J. & Haggerty, R. J. (eds) (1994) Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research, pp. 25. Washington, DC: National Academy Press.
Olin, S. S., John, R. S. & Mednick, S. A. (1995) Assessing the predictive value of teacher reports in a high risk sample for schizophrenia: a ROC analysis. Schizophrenia Research, 16, 5366.
Overall, J. E. & Gorham, D. R. (1962) The Brief Psychiatric Rating Scale. Psychological Reports, 10, 799812.
Strauss, J. S. (1969) Hallucinations and delusions as points on continua function. Archives of General Psychiatry, 21, 581586.
Sullivan, H. S. (1994) The onset of schizophrenia. American Journal of Psychiatry, 151 (suppl. 6), 135139.
Weintraub, S. (1987) Risk factors in schizophrenia: the Stony Brook high-risk project. Schizophrenia Bulletin, 13, 439450.
Young, R. C., Biggs, J. T., Ziegler, V. E., et al (1978) A rating scale for mania: reliability, validity and sensitivity. British Journal of Psychiatry, 133, 429435.
Yung, A. R. & McGorry, P. D. (1996) The prodromal phase of first episode psychosis: past and current conceptualisations. Schizophrenia Bulletin, 22, 353370.
Yung, A. R. & McGorry, P. D. & McFarlane, C. A. (1996) Monitoring and care of young people at incipient risk of psychosis. Schizophrenia Bulletin, 22, 283303.

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Prediction of psychosis: A step towards indicated prevention of schizophrenia

  • Alison R. Yung (a1), Lisa J. Phillips (a2), Patrick D. McGorry (a1), Colleen A. McFarlane (a2), Shona Francey (a3), Susan Harrigan (a4), George C. Patton (a5) and Henry J. Jackson (a3)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *