Objective: Early intervention and prevention of psychosis remain a major challenge. Prediction would be greatly advanced with improved ability to identify individuals at true risk, which, at present, is moderate at best. The authors tested a modified strategy to improve prediction by selecting a more homogeneous high-risk sample (attenuated positive symptom criteria only, age range of mid-teens to early 20s) than is currently standard, combined with a systematic selection of neurodevelopmental deficits.
Method: A sample of 101 treatment-seeking adolescents (mean age, 15.9 years) at clinical high risk for psychosis were followed clinically for up to 5 years (mean follow-up time, 3.0 years, SD=1.6). Adolescents were included only if they exhibited one or more attenuated positive symptoms at moderate to severe, but not psychotic, severity levels. Cox regression was used to derive a risk index.
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In order to earn CME credit, subscribers should read through the material presented in the article. After reading the article, complete the CME quiz online at http://education.psychiatry.org and submit your evaluation and study hours (up to 1 AMA PRA Category 1 Credit™). The course comprises reading the article and answering three multiple-choice questions with a single correct answer. Upon completion of the course, correct answers will be highlighted for the reader’s reference; a score of 60% or higher is required to receive credit. A link from the question to the correct answer in context will be highlighted in the associated article, thus extending the learning experience for people who want to read more. A certificate documenting participation in the course and credits claimed is generated upon completion of the course.
Estimated Time to Complete: 1 hour
Begin Date: October 1, 2015
End Date: September 30, 2017
Title: Psychosis Prevention: A Modified Clinical High Risk Perspective From the Recognition and Prevention (RAP) Program
Authors: Barbara A. Cornblatt, Ph.D., M.B.A., Ricardo E. Carrión, Ph.D., Andrea Auther, Ph.D., Danielle McLaughlin, M.A., Ruth H. Olsen, B.S., Majnu John, Ph.D., Christoph U. Correll, M.D.
Affiliations: From the Division of Psychiatry Research, Zucker Hillside Hospital, North Shore–Long Island Jewish Health System, Glen Oaks, N.Y. (B.A.C., R.E.C., A.A., D.M., R.H.O., M.J., C.U.C.); the Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, North Shore–Long Island Jewish Health System, Manhasset, N.Y. (B.A.C., R.E.C., C.U.C.); and the Department of Psychiatry and Molecular Medicine, Hofstra North Shore–LIJ School of Medicine, Hempstead, N.Y. (B.A.C., C.U.C.).
Disclosures: Dr. Correll has received grant support from, served as a consultant or adviser to, or received honoraria from AbbVie, Actavis, Actelion, Alexza, Alkermes, Bristol-Myers Squibb, Cephalon, Eli Lilly, Genentech, Gerson Lehrman Group, IntraCellular Therapies, Janssen/Johnson & Johnson, Lundbeck, MedAvante, Medscape, Merck, Otsuka, Pfizer, ProPhase, Reviva, Roche, Sunovion, Takeda, Teva, and Vanda. The other authors report no financial relationships with commercial interests.
Discussion of unapproved or investigational use of products*: Yes.
*APA policy requires disclosure by CME authors of unapproved or investigational use of products discussed in CME programs. Off-label use of medications by individual physicians is permitted and common. Decisions about off-label use can be guided by scientific literature and clinical experience.
Robert Freedman, M.D. (Editor in Chief, AJP); Susan K. Schultz, M.D. (Deputy Editor, AJP); Michael D. Roy (Editorial Director, AJP); Michael A. Pogachar (Online Content Manager, Journals).
Dr. Schultz has received research support from the Alzheimer’s Disease Cooperative Study for a project conducted in partnership with Baxter Healthcare. Dr. Freedman, Mr. Roy, and Mr. Pogachar report no financial relationships with commercial interests.
This program is designed for all psychiatrists in clinical practice, residents in Graduate Medical Education programs, medical students interested in psychiatry, and other physicians who wish to advance their current knowledge of clinical medicine.
The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The APA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
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