The role of a family history of psychosis for youth at clinical high risk of psychosis

Early Interv Psychiatry. 2019 Apr;13(2):251-256. doi: 10.1111/eip.12471. Epub 2017 Aug 9.


Aim: On average, there is a 10% to 12% likelihood of developing a psychotic disorder solely based on being at familial high risk. However, the introduction of the criteria for clinical high risk (CHR) of psychosis suggested for CHR individuals, 20% to 30% will go on to develop a full-blown psychotic illness within 3 years. Several studies suggest a role for family history in conversion to psychosis among those at CHR. However, we know very little about those who meet the CHR criteria and have a positive family history for psychosis compared to those at CHR with no known family history. The aim of this study was to compare these 2 groups on demographics, clinical symptoms, social and role functioning, IQ, environmental factors and conversion to psychosis.

Method: A total of 762 participants met criteria for being at CHR, 119 of whom had a family history (CHR + FH) and 643 without (CHR-FH). Groups were compared on attenuated symptoms, role and social functioning, IQ, past trauma, perceived discrimination and cannabis use. Survival analysis was used to compare groups on conversion rates.

Results: There were no major differences between the groups in symptoms, functioning, IQ, cannabis use or in the rate of conversion between the groups. The CHR + FH group reported increased amounts of early trauma.

Conclusion: There is a possibility that CHR + FH individuals believe that it is more difficult for them to cope with circumstances such as abuse or potential abuse. Future research on this subject should investigate family environment and its role in conversion to psychosis among CHR + FH individuals.

Keywords: family risk; prodromal; psychosis.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Female
  • Genetic Predisposition to Disease / genetics*
  • Humans
  • Likelihood Functions
  • Longitudinal Studies
  • Male
  • North America
  • Prodromal Symptoms
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / genetics*
  • Psychotic Disorders / psychology
  • Risk Assessment
  • Social Adjustment
  • Substance-Related Disorders
  • Surveys and Questionnaires
  • Survival Analysis
  • Young Adult