Remission Incidence and Prevalence in Individuals at High Risk for Psychosis

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Researchers in Boston, Massachusetts have conducted a comprehensive study to understand the dynamics of remission in individuals at clinical high risk (CHR) for psychosis. The study, published in the JAMA Network Open, utilizes data from the North American Prodromal Longitudinal Study 3 and examines the incidence, prevalence, and stability of remission over a two-year period. The researchers aimed to characterize the long-term outcomes of CHR individuals and identify factors associated with remission and stability.

Key Takeaways:

  • The study included 692 individuals (mean age 18.7 years, 46% female) at baseline, with 614 completing at least one follow-up.
  • For the symptoms-only definition, 7% of participants 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.
  • Under the symptoms-only definition, 83 out of 153 individuals at CHR with at least one follow-up after remission (54%) were stable remitters.
  • Under the symptoms-and-function definition, 43 out of 91 individuals (47%) were stable remitters.
  • The chance of staying in remission rose drastically once a person had more than one 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; current score for symptoms and function: OR, 1.08; 95% CI, 1.02-1.14).
  • 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; general symptoms for symptoms and function: OR, 0.80; 95% CI, 0.69-0.92).
  • The researchers concluded that continued follow-up and facilitated reengagement with clinical services after remission are essential.

Statistics:

  • Mean age of participants at baseline: 18.7 years (SD 4.1 years)
  • Female participants: 46% (319 out of 692 participants)
  • Remission incidence after 2 months under the symptoms-only definition: 7% (95% CI, 5-10%)
  • Remission prevalence during the study under the symptoms-only definition: 34% (95% CI, 31-38%)
  • Remission incidence after 2 months under the symptoms-and-function definition: 4% (95% CI, 2-5%)
  • Remission prevalence during the study under the symptoms-and-function definition: 21% (95% CI, 18-24%)

Sources:

  • Incidence, Prevalence, and Stability of Remission In Individuals With Clinical High Risk for Psychosis. JAMA Network Open, 2025;8(8).
  • Harvard Medical School, Dept. of Psychiatry, Mass Gen Brigham, Boston, MA, United States.
  • NewsRx. Findings on Psychosis Detailed by Investigators at Harvard Medical School (Incidence, Prevalence, and Stability of Remission In Individuals With Clinical High Risk for Psychosis). Mental Health Weekly Digest, October 27, 2025; p 317.