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The EPOS prediction model improves ability to predict transition to first episode psychosis in individuals at high risk

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Does combining the ultra-high-risk (UHR) and basic symptom-based criterion cognitive disturbances (COGDIS) improve ability to predict transition to first episode psychosis?


Two hundred and forty-five help-seeking adolescents and young adults (ages 16 to 35) predicted by UHR and COGDIS criteria to be in a putatively prodromal state of psychosis. Exclusion criteria: previous psychotic episode lasting longer than a week or prodromal symptoms arising from general medical disorder, or drug or alcohol dependence.


Six early detection outpatient centres in Germany, Finland, the Netherlands and the UK; screening April 2002 to April 2006.

Prognostic factors:

Symptoms (SIPS, BSABS-P and Beck Depression Inventory [BDI]), functioning (Global Assessment of Functioning, GAF-M) and sociodemographic factors. Individual factors were initially assessed using the Cox proportional hazard model, and significant factors were entered into the multivariate Cox regression analysis. The effect of treatment with antidepressants or antipsychotics was also assessed. The prognostic scores based on the final model were used to stratify the participants into four risk groups, from lowest (group I) to highest (group IV) risk.


Transition to psychosis. Full-blown psychotic symptoms were defined as any single item on the positive subscale of SIPS with a score of 6 for more than 7 days. Individuals reaching …

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  • Sources of funding The 5th Framework Program Quality of Life and Management of Living Resources of the European Commission, the Social Insurance Institution of Finland and the Medical Faculty of Cologne.


  • Competing interests AY has received honoraria and travel grants from Eli Lilly, Janssen Cilag, Bristol Myer Squibb and Astra Zeneca, and an Investigator Initiated Research Grant from Janssen Cilag.

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