ArticleSchizophrenia bulletin2017
A Severity-Based Clinical Staging Model for the Psychosis Prodrome: Longitudinal Findings From the New York Recognition and Prevention Program.
Article in Schizophrenia bulletin, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 6 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
31 citing papers in PubMed, 6 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- On the proportion of patients who experience a prodrome prior to psychosis onset: A systematic review and meta-analysis.Molecular psychiatry · 2024Pooled it
- The progress in the field of clinical staging for mental disorders within the last decade: an updated systematic review.Frontiers in psychiatry · 2024Pooled it
- Negative symptoms in children and adolescents with early-onset psychosis and at clinical high-risk for psychosis: systematic review and meta-analysis.The British journal of psychiatry : the journal of mental science · 2023Pooled it
- Is it possible to stage schizophrenia? A systematic review.Translational psychiatry · 2022Pooled it
- What Causes the Onset of Psychosis in Individuals at Clinical High Risk? A Meta-analysis of Risk and Protective Factors.Schizophrenia bulletin · 2020Pooled it
- Negative Symptoms and Functioning in Youth at Risk of Psychosis: A Systematic Review and Meta-analysis.Harvard review of psychiatryPooled it
- Psychosocial Interventions, Recovery, and Mediating Mechanisms in Schizophrenia-Spectrum Disorders: A Systematic Review and Meta-Analysis of Longitudinal Studies.Brain sciences · 2026Review
- Revealing the Unseen: Detecting Negative Symptoms in Students.Journal of clinical medicine · 2024Article
- Intensity of Psychoactive Substance Use Affects the Occurrence of Prodromal Symptoms of Psychosis.Journal of clinical medicine · 2024Article
- Psychedelics action and schizophrenia.Pharmacological reports : PR · 2023Review
- Comprehensive review of multidimensional biomarkers in the ShangHai At Risk for Psychosis (SHARP) program for early psychosis identification.PCN reports : psychiatry and clinical neurosciences · 2023Review
- Epigenetic Targets in Schizophrenia Development and Therapy.Brain sciences · 2023Review
- Clinical, Brain, and Multilevel Clustering in Early Psychosis and Affective Stages.JAMA psychiatry · 2022Article
- Further evidence that antipsychotic medication does not prevent long-term psychosis in higher-risk individuals.European archives of psychiatry and clinical neuroscience · 2022Article
- Treatment Approaches for First Episode and Early-Phase Schizophrenia in Adolescents and Young Adults: A Delphi Consensus Report from Europe.Neuropsychiatric disease and treatment · 2022Article
- Aberrant Salience and Disorganized Symptoms as Mediators of Psychosis.Frontiers in psychology · 2022Article
- Trajectories and predictors of social avoidance in female patients with breast cancer.Frontiers in psychiatry · 2022Article
- Negative Symptom Domains in Children and Adolescents at Ultra-High Risk for Psychosis: Association With Real-Life Functioning.Schizophrenia bulletin open · 2022Article
- The immediate impact of the COVID-19 pandemic on attenuated positive symptoms and functioning in individuals at clinical high risk for psychosis: A pilot study.Schizophrenia research · 2021Article
- The Latent Structure of Negative Symptoms in Individuals With Attenuated Psychosis Syndrome and Early Psychosis: Support for the 5 Consensus Domains.Schizophrenia bulletin · 2021Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
Clinical staging improved the possibility of intervening during the psychosis prodrome to limit progression of illness. The current study aimed to validate a novel 4-stage severity-based model with a focus on clinical change over time and risk for conversion to psychosis. One hundred seventy-one individuals at clinical high risk (CHR) for psychosis were followed prospectively (3 ± 1.6 y) as part of the Recognition and Prevention (RAP) program and divided into 4 diagnostic stages according to absence/presence and severity of attenuated positive symptoms. Twenty-two percent of the combined sample recovered (no prodromal symptoms) by study outcome. The negative symptoms only subgroup had the highest symptom stability (70%), but the lowest conversion rate at 5.9%. The subgroup with more severe baseline attenuated positive symptom levels had a higher conversion rate (28%) and a more rapid onset when compared to the moderate attenuated positive symptom subgroup (11%). Finally, the Schizophrenia-Like Psychosis (SLP) subgroup showed low stability (3%), with 49% developing a specific psychotic disorder. The proposed stage model provides a more finely grained classification system than the standard diagnostic approach for prodromal individuals. All 4 stages are in need of early intervention because of low recovery rates. The negative symptom only stage is possibly a separate clinical syndrome, with an increased risk of functional disability. Both subgroups with attenuated positive symptoms are appropriate for studying the mechanisms of psychosis risk, however, individuals with more severe baseline positive symptoms appear better suited to clinical trials. Finally, the SLP category represents an intermediate outcome group appropriate for preventative intervention research but questionable for inclusion in prodromal studies of mechanisms.
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