Predicting early transition from sub-syndromal presentations to major mental disorders

Abstract

BackgroundTransition from at-risk state to full syndromal mental disorders is underexplored for unipolar and bipolar disorders compared with psychosis.AimsProspective, trans-diagnostic study of rates and predictors of early transition from sub-threshold to full syndromal mental disorder.MethodOne-year outcome of 243 consenting youth aged 15–25 years with a sub-syndromal presentation of a potentially severe mental disorder. Survival analysis and odds ratio (OR) for predictors of transition identified from baseline clinical and demographic ratings.ResultsAbout 17% (n=36) experienced transition to a major mental disorder. Independent of syndromal diagnosis, transition was significantly more likely in individuals who were NEET (not in education, employment or training), in females and in those with more negative psychological symptoms (e.g. social withdrawal).ConclusionsNEET status and negative symptoms are modifiable predictors of illness trajectory across diagnostic categories and are not specific to transition to psychosis.