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


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Abstract

BACKGROUNDThe 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.METHODSA 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.RESULTSOf 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).CONCLUSIONSAPS 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.

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