A new risk calculator can predict an individual’s risk of developing full-blown psychosis after the onset of early warning signs, such as hearing voices, according to a new study published in The American Journal of Psychiatry.
“Until now, clinicians could give patients only a rough estimate of how their condition might progress — that some 15 to 25 percent of people who have experienced early warning symptoms will go on to develop a more serious disorder,” said Larry J. Seidman, Ph.D., a psychologist at Beth Israel Deaconess Medical Center (BIDMC) and Professor of Psychology at Harvard Medical School.
“With this new risk calculator, clinicians can now give patients an individualized assessment of risk. More precise information allows people to have a more realistic sense of what’s going on, which can reduce anxiety.”
Seidman and his colleagues analyzed data from interviews with 596 subjects, ages 12 to 35 years, who were diagnosed with Attenuated Psychosis Syndrome, a condition in which patients may experience hallucinations and/or develop unusual thoughts but recognize their perceptions aren’t based in reality.
The research team, led by Yale University’s Tyrone Cannon, Ph.D., then developed the risk calculator, which analyzes known risk factors for schizophrenia, including the following: stressful life events, trauma, family history, age of onset of symptoms, levels of unusual thought content and suspiciousness, social functioning, verbal learning skills, and speed of mental processing.
After following up with the subjects every six months, the researchers found that 16 percent of the patients diagnosed with Attenuated Psychosis Syndrome had developed psychosis within two years.
The two factors that contributed most to the risk of developing psychosis were having symptoms of unusual thought content and suspiciousness. Other significant factors were a decline in social functioning, lower verbal learning and slower processing speed. People who were younger (in their teens or early twenties) when their symptoms began, were also at increased risk.
Stressful life events, traumas and family history of schizophrenia turned out to have less of an impact on an individual’s risk profile.
“The risk calculator does not take into account treatment or other potentially supportive environmental factors that may reduce risk; this is a direction for future research,” Seidman said, adding that the power of the calculator lies in putting symptoms in perspective for patients and their families.
“Having hallucinations, it turns out, doesn’t add much predictive weight at all. Maybe this person has good cognitive function and has not declined socially — this profile would lead to a good score. Treatment can ensue, potentially with less fear.”