The authors sought to characterize the symptoms of patients later hospitalized for psychotic disorders in primary mental health outpatient settings, and to investigate whether these symptoms can be used to predict later onset of psychotic illness.

This was a population-based historical prospective cohort study using national registers of clinical psychiatric services. The sample (N=114,983) comprised 18- to 21-year-olds serving in the Israeli military and examined in military mental health outpatient clinics across 72 consecutive months.

Overall, 1,092 individuals (0.95%) not diagnosed with a psychotic disorder at the time of examination were hospitalized for nonaffective psychotic disorder up to 9 years after the index examination. A principal components analysis of symptoms presented at index examination found that a symptom cluster of thought disorder, perceptual abnormalities, poor orientation, and suicidality was associated with an increased risk for hospitalization for nonaffective psychotic disorder within 14 days after examination (hazard ratio=45.80, 95% CI=22.87–91.73), 15–111 days after examination, (hazard ratio=19.59, 95% CI=13.08–29.33), 112–365 days after examination (hazard ratio=4.94, 95% CI=2.59–9.40), and 1–3.5 years after examination (hazard ratio=3.42, 95% CI=2.21–5.28), but not for hospitalization 3.5 years or more after examination (hazard ratio=1.57, 95% CI=0.91–2.71). Despite the increased risk, the positive predictive values of this symptom cluster were low, ranging from 0.54% to 1.99%.

In 18- to 21-year-olds, the presence of psychotic symptoms was associated with later hospitalization for a nonaffective psychotic disorder. However, the low positive predictive values of symptoms elicited in primary mental health care settings suggest that symptoms alone are not useful in predicting later hospitalization for nonaffective psychotic disorder.

这组作者试图确定后来在精神疾病门诊就医的精神病患者的症状，并调查这些症状是否可用于预测精神病的较晚发作。

这是一项基于人口的历史前瞻性队列研究，使用了国家精神病学临床服务登记册。样本（N = 114,983）包括在以色列军队中服役的18至21岁的孩子，并连续72个月在军事心理健康门诊进行检查。

总体而言，在检查时未被诊断为精神病的1,092名患者（0.95％）在进行指数检查后的9年内因非情感性精神病而住院。进行指标检查时出现的症状的主成分分析发现，思想障碍，知觉异常，定向不良和自杀倾向的症状群与检查后14天内非情感性精神病住院的风险增加相关（危险比= 45.80， 95％CI = 22.87-91.73），检查后15-111天，（危险比= 19.59，95％CI = 13.08-29.33），检查后112-365天（危险比= 4.94，95％CI = 2.59-9.40 ）和检查后1–3.5年（危险比= 3.42，95％CI = 2.21–5.28），但对于检查后3.5年或更长时间的住院（危险比= 1.57，95％CI = 0.91–2.71）。尽管风险增加，但该症状群的阳性预测值较低，范围为0.54％至1.99％。

在18至21岁的年龄段，精神病性症状的出现与非情感性精神病性疾病的随后住院治疗有关。但是，在初级精神卫生保健机构中引起的症状的低阳性预测值表明，仅症状对预测非情感性精神病性疾病的后续住院无用。