Characterizing covariant trajectories of individuals at clinical high risk for psychosis across symptomatic and functional domains

Differences in outcomes among help-seeking individuals at clinical high risk for psychosis were sought to be characterized by identifying covariant longitudinal patterns of symptoms and functioning. Researchers applied group-based multitrajectory modeling to longitudinal ratings of four symptom domains (positive, negative, disorganized, general) and general functioning among clinical high-risk individuals in an initial discovery sample (N = 422). In the discovery sample, high-risk individuals were identified to comprise three trajectory groups: group 1 (30%) that showed substantial improvement across all domains, with half reaching positive outcomes for both functioning and positive symptoms; group 2 (49%) that showed moderate impairments across domains, with nearly one-quarter meeting criteria for positive outcomes; the remaining participants for the group 3 (22%) that showed consistent levels of severe impairment across domains and did not experience positive outcomes. In an independent sample (N = 133), replication of these trajectory groups and remission patterns was achieved. The observed trajectory subgroups suggest that clinical interventions are required in different degrees, ranging from minimal or supportive for about one-third of cases to increasingly intensive among the remainder.