Unfavorable short-term outcome indicators in young people at clinical high risk for psychosis: preliminary results from the “Parma At-Risk Mental States” (PARMS) program.

Objective Despite advances in the implementation of “Early Intervention in Psychosis” (EIP) services, people at Clinical High Risk (CHR) are still difficult to identify and follow up. Moreover, outcomes other than psychosis conversion are relatively under-estimated and were not systematically reported, thereby compromising further, more sophisticated, prognostic stratifications. Thus, the aims of this study were: (1) to investigate unfavorable short-term outcome indicators (i.e. drop-out rate, psychosis conversion rate, hospital admission rate, longitudinal functioning decline, persistence of CHR-P criteria) in an Italian CHR sample across a 1-year follow-up period, and (2) to examine any significant associations with sociodemographic and clinical characteristics. Methods All participants completed a sociodemographic/clinical schedule, the “Health of Nation Outcome Scale” (HoNOS) and the Global Assessment of Functioning (GAF) scale. Inter-group comparisons, Kaplan-Meier survival analysis and Cox regression analysis were performed. Results A total of 57 CHR-P subjects was enrolled in this study. At the end of the follow-up, 14% of them transitioned to psychosis, 24% dropped out, 36% had a persistence of CHR-P criteria, 22% were hospitalized and 23%s showed a significant longitudinal functioning decline. Conclusions As 1/4 of our participants remitted overtime, sustained clinical attention for CHR people should be provided in the longer term, also to monitor unfavorable outcomes and to improve prognosis.