OBJECTIVE The authors sought to characterize differences in outcomes among help-seeking individuals at clinical high risk for psychosis by identifying covariant longitudinal patterns of symptoms and functioning. METHODS Group-based multitrajectory modeling was applied to longitudinal ratings of four symptom domains (positive, negative, disorganized, general) and general functioning among clinical high-risk individuals in an initial discovery sample (N=422). An independent sample (N=133) was used to test replicability. RESULTS Three trajectory groups were identified among clinical high-risk individuals in the discovery sample: group 1 (30%) exhibited substantial improvement across all domains, with half reaching positive outcomes for both functioning and positive symptoms; group 2 (49%) exhibited moderate impairments across domains, with approximately one-quarter meeting criteria for positive outcomes; the remaining participants (group 3; 22%) exhibited consistent levels of severe impairment across domains and did not experience positive outcomes. These trajectory groups and remission patterns were replicated in an independent sample. CONCLUSIONS Replicable subgroups of help-seeking clinical high-risk cases can be ascertained based on distinctive profiles of change over time in symptoms and functioning. Within each of the three identified subgroups, similar patterns of change (i.e., rapid, moderate, or no improvement) were observed across the four symptom domains and functioning. This consistency of change over time across domains within each subgroup is a novel observation supporting the syndrome consistency of clinical high-risk symptoms and signs. The observed trajectory subgroups are suggestive of different degrees of need for clinical interventions, ranging from minimal or supportive for about one-third of cases to increasingly intensive among the remainder.

中文翻译：

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跨症状和功能域表征精神病临床高风险个体的协变轨迹。

目的作者试图通过识别症状和功能的协变纵向模式来表征在临床上有精神病高风险的寻求帮助者之间的结局差异。方法将基于组的多轨迹模型应用于四个症状域（阳性，阴性，无序，一般）的纵向评分以及初始发现样本中临床高风险个体的一般功能（N = 422）。使用独立样本（N = 133）测试可重复性。结果在发现样本的临床高危人群中确定了三个轨迹组：第1组（30％）在所有领域均表现出显着改善，其中一半在功能和阳性症状方面均取得了积极成果；第2组（49％）在各个域中表现出中等程度的损伤，约有四分之一的满足积极结果的标准；其余参与者（第3组； 22％）在各个领域表现出一致的严重损伤水平，并且未见积极结果。这些轨迹组和缓解模式被复制到一个独立的样本中。结论可根据症状和功能随时间变化的独特特征确定寻求帮助的临床高危病例的可重复亚组。在三个确定的亚组中，在四个症状域和功能中观察到相似的变化模式（即快速，中度或无改善）。每个亚组内跨域随时间变化的一致性是一种新颖的观察结果，支持临床高危症状和体征的综合征一致性。