Although the clinical high risk for psychosis (CHR) paradigm has become well-established over the past two decades, one key component has received surprisingly little investigative attention: the predictive validity of the criteria for conversion or transition to frank psychosis. The current study evaluates the predictive validity of the transition to psychosis as measured by the Structured Interview for Psychosis-Risk Syndromes (SIPS) in CHR individuals. Participants included 33 SIPS converters and 399 CHR non-converters both from the North American Prodromal Longitudinal Study (NAPLS-2), as well as a sample of 67 separately ascertained first-episode psychosis (FEP) patients from the STEP program. Comparisons were made at baseline and one-year follow-up on demographic, diagnostic stability (SCID), and available measurement domains relating to severity of illness (psychotropic medication, psychosocial treatment, and resource utilization). Principal findings are: 1) a large majority of cases in both SIPS converters (n = 27/33, 81.8%) and FEP (n = 57/67, 85.1%) samples met criteria for continued psychosis at one-year follow-up; 2) follow-up prescription rates for current antipsychotic medication were higher in SIPS converters (n = 17/32, 53.1%) compared to SIPS non-converters (n = 81/397, 20.4%), and similar as compared to FEP cases (n = 39/65, 60%); and 3) at follow-up, SIPS converters had higher rates of resource utilization (psychiatric hospitalizations, day hospital admissions, and ER visits) than SIPS non-converters and were similar to FEP in most categories. The results suggest that the SIPS definition of psychosis onset carries substantial predictive validity. Limitations and future directions are discussed.

中文翻译：

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从临床高危综合征转变为明显精神病的预测有效性


尽管临床精神病高风险（CHR）范式在过去二十年中已经得到了广泛的认可，但令人惊讶的是，一个关键组成部分却很少受到研究关注：即转变为或转变为坦率精神病的标准的预测有效性。目前的研究通过 CHR 个体的精神病风险综合征结构化访谈 (SIPS) 来评估向精神病转变的预测有效性。参与者包括来自北美前驱纵向研究 (NAPLS-2) 的 33 名 SIPS 转化者和 399 名 CHR 未转化者，以及来自 STEP 项目的 67 名单独确定的首发精神病 (FEP) 患者样本。在基线和一年随访中对人口统计学、诊断稳定性 (SCID) 以及与疾病严重程度相关的可用测量领域（精神药物、心理社会治疗和资源利用）进行了比较。主要发现是：1) SIPS 转换器（n = 27/33，81.8%）和 FEP（n = 57/67，85.1%）样本中的绝大多数病例在一年的随访中符合持续精神病的标准; 2) 与 SIPS 未转化者 (n = 81/397, 20.4%) 相比，SIPS 转化者 (n = 17/32, 53.1%) 当前抗精神病药物的后续处方率较高，与 FEP 病例相似（n = 39/65，60%）； 3) 在随访中，SIPS 转化者比 SIPS 未转化者具有更高的资源利用率（精神病住院、日间住院和急诊就诊），并且在大多数类别中与 FEP 相似。结果表明，SIPS 对精神病发作的定义具有显着的预测有效性。讨论了局限性和未来的方向。