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Time to psychosis progression increases most in first months following clinical presentation

Psychosis progression among patients at ultra-high clinical risk is greatest during the first months after clinical presentation, according to study findings in JAMA Psychiatry.

“The transition to psychosis in patients at ultra-high clinical risk is most likely to occur within the first 2 years after presentation to clinical services,” study researcher Matthew J. Kempton, MSc, PhD, of King’s College London, and colleagues wrote. “However, the exact speed of psychosis progression at a particular point during the critical first 2 years is unclear, preventing clinical advancements in the field.”

Kempton and colleagues analyzed a previously conducted meta-analysis with a combined cohort of 1,327 patients.

Statistical analysis indicated that 2% of ultra-high risk individuals would transition to psychosis within the first month after clinical presentation. This effect decreases for each subsequent month, indicating that at 12 months after presentation, approximately 1% of patients would be expected to transition per month.

Among ultra-high risk patients who will eventually progress to psychosis within 2 years of clinical presentation, 25% will do so by 106 days and 50% by 240 days, according to researchers.

“These findings are important, particularly because the duration of the [ultra-high clinical risk] state is known to impact clinical outcomes and underlying neurobiology. It seems relevant to reduce the waiting list time to start the treatment and to offer close-in weekly monitoring to [ultra-high clinical risk] patients who refuse the psychological intervention,” Kempton and colleagues wrote. “High-risk services should place more emphasis in conducting a prolonged and ongoing careful assessment to rule out concealed psychotic symptoms.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.