DSM-5-defined attenuated psychosis syndrome and conversion to full-scale schizophrenia spectrum disorders: An institution-wide retrospective review

Ann Clin Psychiatry. 2016 Nov;28(4):245-254.

Abstract

Background: The objective of the study was to determine if DSM-5-defined attenuated psychosis syndrome (APS) could identify individuals with prodromal psychosis and predict conversion to schizophrenia spectrum disorders at a rate similar to that observed in previous studies that utilized structured interviews and specialized rating scales.

Methods: A retrospective review of patients' medical records was used to identify individuals meeting diagnostic criteria for the APS, followed by further evaluation 2 to 3 years after the initial diagnosis, to determine if they converted to schizophrenia spectrum disorders. Results then were compared with previous studies.

Results: Of our study population, 43.4% converted to schizophrenia or schizoaffective disorder 2 to 3 years after initial diagnosis of APS. Comparison at the 3-year mark indicated that there was no significant difference between our observed rates and previously published conversion rates (P = .066). Three covariates were found to increase significantly the rates of conversion when added to the APS criteria: Cannabis use (P = .048), lack of previous Axis I diagnosis (P = .005), and lack of previous treatment with psychotropic medications (P = .009).

Conclusions: APS accurately predicts conversion to full-scale schizophrenia spectrum disorders at a rate similar to that observed in previous studies using structured interviews and specialized rating scales.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Diagnostic and Statistical Manual of Mental Disorders*
  • Female
  • Humans
  • Male
  • Psychiatric Status Rating Scales
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / epidemiology*
  • Retrospective Studies
  • Time Factors
  • Young Adult