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Which Teens Will Do Well Despite Risk for Psychosis?

September 18, 2013. A new study of adolescents and young adults at high risk for developing psychosis finds that long-term functional outcome—how well patients perform in tasks of daily life—is dependent on more than just whether or not they eventually "convert" to a full-blown psychotic disorder. Instead, the study identifies factors, such as impaired cognitive performance, that are much better at determining who will have functional difficulties later on. The findings, published online September 4, 2013, in JAMA Psychiatry, suggest that the early identification and treatment of these problems could help ward off long-term functional disability and improve quality of life.

Researchers led by Ricardo Carrión of the Zucker Hillside Hospital in Glen Oaks, New York, examined 92 teens and young adults who showed signs of psychosis (such as delusional ideas) that are troubling but aren’t strong enough to meet the criteria for a full-blown psychotic disorder. Studies have shown that this group is more likely to eventually convert to a formal disorder than the general population. The researchers examined the high-risk teens' social and occupational functioning at baseline and some three years later, and found three factors that predicted poor long-term functional outcome: performing poorly on cognitive tests, already having functional difficulties, or displaying stronger non-psychotic symptoms. Nearly 20 percent of the at-risk teens went on to develop psychosis, but almost 50 percent of those who didn’t still showed long-term social problems or trouble with school/work, suggesting that they, too, could benefit from early therapies to improve their functional outcome. (For more details, see the related news story.)—Allison A. Curley.

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