S244. Characterizing Outcomes Of Clinical High-Risk Non-Converters Using Group-Based Trajectory Modeling

• Type of Material: Article
• Authors: Dana Allswede, Yale University; Tyrone Cannon, Yale University; Jean Addington, University of Calgary; Carrie Bearden, University of California, Los Angeles; Kristin Cadenhead, University of California, San Diego; Barbara Cornblatt, The Zucker Hillside Hospital; Daniel Mathalon, University of California, San Francisco; McGlashan Thomas, Yale University; Diana Perkins, University of North Carolina; Larry Seidman, Harvard Medical School; Ming Tsuang, University of California, San Diego; Elaine Walker, Emory University; Scott Woods, Yale University
• Language: English
• Date: 2018-04-01
• Publisher: Oxford University Press (OUP): Policy B - Oxford Open Option D
• Publication Version: Final Published Version
• Copyright Statement: © Maryland Psychiatric Research Center 2018.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1093/schbul/sby018.1031
• Title of Journal or Parent Work: Schizophrenia Bulletin
• ISSN: 0586-7614
• Volume: 44
• Issue: suppl_1
• Start Page: S422
• End Page: S422

Abstract

Background The development of the clinical high-risk (CHR) prodromal criteria has facilitated advancement in understanding conversion to psychosis and has provided opportunities for early intervention and treatment for these individuals. However, the majority of CHR cases do not meet full criteria for conversion, yet continue to experience clinically significant symptoms and impairment in daily functioning. It is likely that many of these individuals would also benefit from additional intervention and treatment, but the outcomes and needs of these “non-converters” are not well characterized. Identifying common longitudinal patterns of symptoms and functioning of non-converters would support the identification of individuals who continue to require treatment and tailoring of services to their specific needs. Methods We used group-based trajectory modeling to identify common longitudinal symptom and functioning trajectories among CHR cases (N=561) in the second phase of the North American Prodrome Longitudinal Study (NAPLS2). Covariant trajectories of symptoms (including positive, negative, disorganized, and general) and functioning (including role and social) were examined. Models were tested for replicability in an independent sample of CHR cases (N=291) from the first phase of NAPLS (NAPLS1). Results We identified a subgroup of individuals who exhibited symptom remission and functioning within the normal range, as well as at least two additional subgroups that exhibited different patterns of ongoing, clinically significant symptoms and functional deficits. Discussion We are currently investigating the validity of these subgroups by assessing their association with a variety of risk factors and biomarkers.