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About a third of individuals at high risk for psychosis manifest frank psychosis within 3 years. What about the rest? Investigators in Australia performed a partially industry-funded follow-up study of 331 patients assessed as ultra-high risk between ages 15 and 30. Ultra-high risk was defined as having attenuated psychotic symptoms, brief intermittent psychotic symptoms, or worsening psychosocial function plus trait vulnerability (schizotypal personality disorder or family history of psychosis). At baseline, 90% had at least one comorbid axis I disorder — mood disorders in 71%, anxiety disorders in 40%, and substance use disorders in 22%.
During a mean follow-up of 7 years (range, 2–14 years), 85 individuals developed frank psychosis. At fo…