Outcomes of the “converted” ARMS: a long-term follow-up study

Poster C108, Saturday, October 22, 11:30 am - 1:00 pm, Le Baron

Kyoko Kokubun1, Masahiro Katsura2, Shiori Sato2, Noriyuki Ohmuro2,3, Chika Obara2, Koichi Abe1, Hiroo Matsuoka1,2, Kazunori Matsumoto2,4; 1Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan, 2Department of Psychiatry, Tohoku University Hospital, Sendai, Japan, 3Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK, 4Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan

Background: Research on the At-Risk Mental State (ARMS) has focused on the rate of conversion to full-blown psychosis and then the long-term progress of those who do not experience this conversion. However, the long-term progress of the “converted” cases has not been clarified. Methods: One hundred and twenty-six individuals were identified as ARMS in our specialized clinic for ARMS. Seventeen of these individuals transitioned to psychosis; the estimated transition rate was 19.4 ± 5.6 % at 48 months. We conducted follow-up interviews with these converters. Results: Among the 17 converters, one had committed suicide and four were under treatment but refused to join the study. Thus, 12 converters (mean age, 25.3± 3.7 years; female, 75 %; mean period since intake, 6.1 ± 2.5 years) consented to undergo interviews. Of them, eight were still under treatment with antipsychotics. Two of the patients who were being treated presented psychotic symptoms and three had attenuated psychotic symptoms. Although the remaining four untreated converters stopped seeing their doctors, two of them indicated their intention to restart psychiatric treatment because of their psychiatric, but not psychotic, symptoms. The average Social and Occupational Functioning Assessment Scale score of the 12 individuals was 59.2 ± 11.0. Discussion: Although most of the converters needed long-term psychiatric treatment, their symptomatic and functional outcomes were diverse. The psychosis threshold is based on arbitrary clinical symptoms and “conversion” to psychosis does not necessarily predict the long-term outcome. Development of more precise indicators, other than psychotic symptoms, is necessary.

Topic Area: Ultra High Risk / Prodromal Research

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