Clinical Edge

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Predicting Conversion to Psychosis

Consider using these four variables

The use of 4 variables enabled researchers to improve their predictive accuracy of conversion to psychosis in a study of 101 treatment-seeking adolescents.

Subjects averaged 16 years of age and were at clinical high risk for psychosis. They were included if they showed one or more attenuated positive symptoms at moderate to severe levels. Investigators followed them for up to 5 years (mean of 3 years).

28.3% of the subjects converted to psychosis. The model developed by researchers had a positive predictive validity of more than 80%. The model include these 4 variables:

• disorganized communication

• suspiciousness

• verbal memory deficits

• decline in social functioning

The authors noted that the results suggest limiting the risk age range to between 15 and 22 years. Additionally, in their model:

• low scores signify minimal risk

• intermediate scores support psychosocial treatment

• high scores suggest aggressive treatment

Citation: Cornblatt B, Carrion R, Auther A, et al. Psychosis prevention: A modified clinical high risk perspective from the recognition and prevention (RAP) program. Am J Psychiatry. 2015;172(10):986-994.