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Harvard University. Harvard Medical School

Remission from Clinical High Risk for Psychosis is Not as Stable as Thought

Strategic Insights

— 1 min read

A new cohort study from the North American Prodromal Longitudinal Study 3 examined data from individuals aged 12 to 30 years at clinical high risk for psychosis. The research aimed to characterize remission incidence, prevalence, and stability, comparing two commonly used definitions. The findings suggest that clinical high risk status is a dynamic state, and vulnerability can persist even after functional remission.

Key Takeaways:

  • The study examined data from 692 individuals with a mean age of 18.7 years, with 319 (46%) being female.
  • For the symptoms-only definition, 7% met remission criteria after 2 months, 34% met remission criteria at least once during the study, and 26% met criteria at their last visit.
  • The symptoms-and-function definition was associated with a lower remission incidence and prevalence, with 4% meeting remission criteria after 2 months, 21% meeting criteria at least once, and 15% meeting criteria at their last visit.
  • The chance of staying in remission rose drastically once a person had more than 1 previous recorded remission visit.
  • Higher functioning was associated with a higher likelihood of remission (current score for symptoms only: OR, 1.04; 95% CI, 1.01-1.08).
  • More symptoms at baseline was associated with a lower likelihood of remission (general symptoms for symptoms only: OR, 0.77; 95% CI, 0.70-0.84).

Statistics:

  • 692 individuals were included in the sample, with a mean age of 18.7 years.
  • 319 (46%) of the sample were female.
  • For the symptoms-only definition, 7% of individuals met remission criteria after 2 months, with a relative risk of 34% meeting remission criteria at least once during the study.
  • The symptoms-and-function definition was associated with a lower remission incidence and prevalence, with 4% of individuals meeting remission criteria after 2 months, 21% meeting criteria at least once, and 15% meeting criteria at their last visit.
  • The odds ratio for higher functioning being associated with remission was 1.04 (95% CI, 1.01-1.08).
  • The odds ratio for more symptoms at baseline being associated with non-remission was 0.77 (95% CI, 0.70-0.84).

Sources:

  • Incidence, Prevalence, and Stability of Remission In Individuals With Clinical High Risk for Psychosis. JAMA Network Open, 2025;8(8).
  • Amer Medical Assoc, 330 N Wabash Ave, Ste 39300, Chicago, IL 60611-5885, USA.
  • Johanna Seitz-Holland, Harvard Medical School, Dept. of Psychiatry, Mass Gen Brigham, Boston, MA, United States.

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