. 2006 Jun 16;32(3):538–555. doi: 10.1093/schbul/sbj077

Table 1.

Description of Clinical High Risk Studies by Programs: Method, Cognition Results, and Main Conclusions

Program Investigators	N	Age	Clinical High-Risk Subject Group: Diagnostic and Risk Characteristics	Follow-up Duration/Transition Rate	Cognitive Assessments	Cognitive Battery Raw Scores	Main Findings
PACE (Yung et al. 1996)
Brewer et al. 1996 (Abs)⁶⁹	UHR = 17 CTL = 22	N/A	N/A	Baseline only	COGMAPS UPSIT	N/A	Deficits in olfactory identification
Brewer et al. 1998 (Abs)⁷⁰	UHR = 65 CTL = 24	N/A	N/A	18/12 follow-up / 21 (32%) UHR-P	COGMAPS UPSIT	N/A	Deficits in Current IQ, attention, memory, and executive function, and olfactory identification at baseline; Mental arithmetic poorer in UHR-P compared to UHR-NP
Brewer et al 2003⁷⁴	UHR = 81 CTL = 31	19.9 (4.1) P 20.4 (3.2) NP 21.1 (3.9) 14–30 years	Attenuated = 48.1% BLIPS = 11.1% T&S = 13.6% Attenuated/BLIP = 1.2% Attenuated/T&S = 11.1% BLIPS/T&S = 12.3% All 3 = 2.5% Remaining 10 UHR-P not Scz: Dep with psychotic features (n = 2); Schizaff- Dep (n = 1); Bipolar (n = 3); Psychotic disorder NOS (n = 3); Substance- induced psychosis (n = 1)	18/12 follow-up / 22 (27.2%) UHR-P, of whom 12 developed Scz	NART UPSIT	NART IQ: UHR-P = 99.9 (Scz) = 96.8 (Spectrum) = 103.6 UHR-NP = 100.5 CTL = 108.5 UPSIT: UHR-P = 31.2 (Scz) = 29.8 (Spectrum) = 32.9 UHR-NP = 32.2 CTL = 33.4	Deficit in olfactory identification in UHR-P
Wood et al. 2003⁷⁸	UHR = 38 CTL = 49	18.3 (3.2) P 19.7 (2.8) NP 20.3 (2.7) 14–30 years	Attenuated = 36.8% BLIPS = 2.6% T&S = 26.3% Attenuated/BLIPS = 2.6% Attenuated/T&S = 31.6%	12-24/12 follow-up / 9 (23.7%) UHR-P	NART CANTAB	NART IQ: UHR-P = 92.8 UHR-NP = 101.7 CTL = 100.3	UHR impaired on Spatial Span, SWM, and DMTS; NS trend for UHR-P poorer on SWM; WM linked to negative symptoms in UHR group generally
Brewer et al. 2005⁷⁹	UHR = 98 CTL = 37	19.4 (4.0) P 20.0 (3.6) NP 20.7 (4.3) 15–29 years	Attenuated = 44.9% BLIPS = 13.3% T&S = 15.3% Attenuated/BLIPS = 1.0% Attenuated/T&S = 11.2% BLIPS/T&S = 11.2% All 3 = 3.1% Remaining 16 UHR-P not Scz: Dep with psychotic features (n = 5); Schizaff (n = 1); Bipolar (n = 4); Psychotic disorder NOS (n = 3); Substance-induced psychosis (n = 1); Brief psychotic disorder (n = 2) UHR-NP: Dep (n = 4); GAD (n = 2); OCD (n = 1); Social phobia (n = 2); Dysthymia (n = 2); Adjustment disorder (n = 1); PTSD (n = 1)	12/12→follow-up / 34 (34.7%) UHR-P WMS-R Vis Rep	NART 7 Subtest WAIS-R WMS-R VMI 3-trial RAVLT Trails A & B COWAT Stroop¹¹⁸	NART IQ: UHR-P = 99.3 UHR-NP = 100.4 CTL = 108.1 WAIS-R VIQ: UHR-P = 99.2 UHR-NP = 98.5 CTL = 103.8 WAIS-R PIQ: UHR-P = 100.6 UHR-NP = 102.4 CTL = 111.6 WMS-R Vis Rep Raw: UHR-P = 32.1 UHR-NP = 35.3 CTL = 36.0 WMS-R VMI: UHR-P = 82.2 UHR-NP = 91.1 CTL = 96.7 RAVLT 3-trials: UHR-P = 9.6 UHR-NP = 9.6 CTL = 9.6 Trails A/B Seconds: UHR-P = 26.8/70.3 UHR-NP = 28.0/70.8 CTL = 23.4/61.0 COWAT: UHR-P = 35.4 UHR-NP = 37.2 CTL = 33.7 Stroop interference D/B: UHR-P = 0.46 UHR-NP = 0.49 CTL = 0.46	UHR deficits: VIQ, Block Design, Vis Rep UHR-P deficits: VMI (Logical Memory), Vis Rep UHR-NP deficits: Digit Symbol UHR did not improve in IQ between premorbid and current as did CTL
Francey et al. 2005⁸¹	UHR = 70 CTL = 51	20.9 P 19.9 NP 23.3 14–30 years	Attenuated = 42.9% BLIPS = 15.7% T&S = 14.3% Attenuated/BLIPS = 14.3% Attenuated/T&S = 12.9% Remaining 12 UHR-P not Scz: Dep with psychotic features (n = 3); Schizaff (n = 1); Bipolar (n = 3); Psychotic disorder NOS (n = 3); Substance-induced psychosis (n = 1); Brief psychotic disorder (n = 1) UHR-NP: None (n = 28) Dep (n = 4); GAD (n = 1); Panic disorder (n = 2); Social phobia (n = 1); Dysthymia (n = 4); Adjustment disorder (n = 1)	12/12 follow-up / 20 (28.6%) UHR-P (n = 21 UHR received low-dose neuroleptics and therapy)	NART CPT-IP	NART IQ N/A CPT-IP Raw Scores N/A	UHR CPT deficits compared to CTL; however, of those who developed psychosis, there were no differences to those who did not develop psychosis.
Koutsouradis et al. 2005⁸⁶	UHR = 16 CTL = 17	N/A	N/A	12-18/12 follow-up / 7 (43.8%) UHR-P	COGMAPS	N/A	Visual reproduction, verbal fluency, and Trails B all showed significant declines over the transition to psychosis, while cognitive performance for UHR-NP group remained stable or improved
RAP
Lencz et al. 2005¹²	CHR = 38 CTL = 39	16.5 (2.2) 15.8 (2.6)	n = 23 (60.5%) neuroleptic-free	6/12→follow-up / 12 (31.6%) CHR-P	WRAT-III WISC-III/WAIS-R Vocab Block Design Digit Span WMS-R Log Mem I/II Vis Rep I/II CVLT WCST COWAT TRAILS A/B Ruff Figural Fluency¹¹⁹ Letter-Number Span CPT-IP Finger Tap¹²⁰ Groove Pegboard¹²¹ Line Judgment¹²² Boston Naming Test¹²³	WRAT IQ: UHR = 101.0 CTL = 108.0 WAIS-R FSIQ (Prorated): UHR = 97.5 CTL = 110.0 Further individual scores not reported Cognitive Domains: (z-score deficits compared to CTL): Cognitive Domains: (z-score deficits compared to CTL): Verbal Memory z = 1.8 Executive/WM z = 1.6 Language z = 1.3 Motor z = 1.2 Attention z = 1.0 Visuo-spatial z = 0.75 Verbal Memory: CHR-P z = 2.8 CHR-NP z = 1.2 CPT Raw Scores N/A	CHR impaired on global cognition, along with verbal memory and executive function/working memory, while visuo-spatial relatively spared; CHR-P had lower verbal memory at baseline.
Smith et al. 2006⁹⁴	CHR = 8 CTL = 10	16.3 (2.6) 16.6 (2.9)	Comorbidity: Anxiety (n = 4); Dep (n = 2); ADHD (n = 2) 10 low-risk CTL (1 year extra education).	Baseline only	WISC-III/WAIS-R Vocab Block Design Computerized SWM task	Prorated IQ: CHR = 108.0 CTL = 111.9	SWM deficits in CHR but not on a non-WM-demanding spatial control task.
PRIME
Hawkins et al. 2004⁹⁸	CHR = 36 CTL = comparable published norms from Test Manuals and Goldberg's¹²⁴ discordant twin samples	19.8 (4.7) 16–45 years	Not reported	Not reported	WAIS-R 4 subtest CPT-IP 450 Letter/Number Sequencing Dot location Trails A/B Stroop Finger tapping CVLT WMS-R Vis Rep I/II COWAT Ruff Figural Fluency	WAIS-R Vocab SS: UHR = 10.8 Norm = 10.0 WAIS-R Info SS: UHR = 9.8 Norm = 10.0 WAIS-R Block Design SS: UHR = 9.8 Norm = 10.0 WAIS-R Digit Symbol SS: UHR = 8.9 Norm = 10.0 WMS-R Vis Rep I Raw Score: UHR = 33.0 Norm = 34.0 WMS-R Vis Rep II Raw Score: UHR = 31.9 Norm = 31.5 CVLT: UHR = 50.5 Norm = 55.9 Trails A/B Seconds: UHR = 28.6/76.5 Norm = 26.6/54.3 COWAT: UHR = 32.5 Norm = 43.7 Stroop: UHR = 39.8 Norm = 49.8 Letter/Number Sequencing: UHR = 13.8 Norm = 15.7 Dot Location: UHR = 0.63 Norm = 1.27 Ruff Figural Fluency: UHR = 83.7 Norm = 107.5 CPT 450 D': UHR = 1.2 Norm = 0.8	UHR poorer on digit symbol, Vocab, CPT, Letter/Number Sequencing, Dot Location, Trails B, CVLT, COWAT, and Figural Fluency; normal on Trails A, WMS-R Vis Rep I/II, and CVLT Total Recall.
FEPSY
Gschwandtner et al. 2003⁹⁹	CHR = 32 CTL = 32	26.5 (8.8) 25.5 (4.4)	Not reported	Baseline only	WCST Twr of Hanoi¹²⁵ TAP CPT	WCST Perseverations (%): CHR = 26.6 CTL = 15.6 Twr of Hanoi (seconds): CHR = 468 CTL = 299 TAP GoNoGo R/T (ms): CHR = 585 CTL = 488 TAP WM R/T (ms): CHR = 784 CTL = 550 TAP WM (missed): CHR = 4.0 CTL = 1.3 CPT R Time (ms): CHR = 494 CTL = 399	UHR higher perseveration and prolonged reaction times in Twr of Hanoi; GoNoGo, WM, and CPT reaction also deficit.
Gschwandtner et al. 2005¹⁰⁰	CHR = 40 CTL = 42	27.4 (9.1) 25.9 (5.2)	Not reported	Baseline only	WCST Twr of Hanoi TAP CPT	Verbal IQ: CHR = 105.2 CTL = 119.0 Nonverbal IQ: CHR = 111.1 CTL = 118.8 WCST Perseverations: CHR = −0.08 CTL = 0.23 WCST Perseverative Error: CHR = −0.13 CTL = 0.31 Twr of Hanoi (moves): CHR = −0.05 CTL = −0.09 TAP WM False Alarm: CHR = −0.34 CTL = 0.34 TAP WM Missing: CHR = −0.44 CTL = 0.39 TAP GoNoGo False Alarm: CHR = −0.24 CTL = 0.13 TAP GoNoGo Missing: CHR = −0.38 CTL = 0.12 CPT Missing: CHR = −0.32 CTL = 0.34 CPT False Alarm: CHR = −0.39 CTL = 0.38	UHR deficits in sustained attention, WM, and perseveration.
PAS
Silverstein et al. 2006¹⁰⁷	UHR = 70 CTL = 24	17.4 (3.6) 20.7 (4.4)	Trait = GAF drop of 30 points (n = 11); Attenuated (n = 38); BLIPS (n = 21)	18-24/12 follow-up / 49 assessed, of whom 24 (49.0%) UHR-P	NART Computerized Perceptual Organization Task		No differences between UHR and CTL
Schall et al. 2003¹⁰⁹	UHR = 103	N/A		12-36/12 follow-up / 62 (55.3%) of original UHR (n = 112) UHR-P	WCST Stroop Trails B Verbal Recall	N/A	UHR higher error rates on WCST, Stroop, and Trails B; UHR-P poorer in Verbal Memory at baseline
CARE
Shafer et al. 2003	UHR = 27 CTL = 17	N/A	N/A	Baseline only	CPT-IP	N/A	UHR attentional deficits intermediate to CTL and FEP
University of Drebecen
Bartok et al. 2005²⁴	CHR = 11	25.0 (5.0) 19–40 years		12/12 follow-up / 9 (81.82%) CHR-P	CANTAB		CHR impaired on PAL, SRM, RVP, and SWM compared to CTL; No difference between UHR-P and UHR-NP
FETZ
Hambrecht et al. 2002¹¹²	CHR = 29 CTL = 29	23.1 (4.4) 24.0 (3.0) 15–31 years	Not reported	15/12 follow-up / 5 (9.8%) of larger cohort (n = 51), 29 of which received cognitive assessment	Matched by Verbal IQ, measured by 37 series of 4 nonwords, and 1 word has to be identified Visual BM CPT- IP SWM (DR) Task RAVLT COWAT (+ category) Rey Figure WCST Perseverative Errors;	Visual BM (% hits): UHR = 84.7 CTL = 86.9 Attention (% hits): UHR = 72.7 CTL = 81.5 RAVLT: UHR = 11.2 CTL = 12.1 Recognition: UHR = 14.0 CTL = 14.1 COWAT: UHR = 17.6 CTL = 21.6 Visual Recall (Rey copy less delay): UHR = 12.4 CTL = 8.9 WCST (% perseveration): UHR = 11.4 CTL = 10.8	Self perceived deficits in perception, cognition, and stress reactivity; CHR worse on verbal recall, verbal fluency, attention, and visual memory, though only fluency after Bonferroni corrections; CTL had higher premorbid IQ

Note: Abbreviations—Abs: Abstract; ADHD: Attention Deficit Hyperactivity Disorder; BLIPS: Brief Limited Intermittent Psychotic Symptoms²²; BM: Backward Masking; CANTAB: Cambridge Neuropsychological Testing Automated Battery⁷⁷; CARE: Cognitive Assessment and Risk Evaluation Program, University of California, San Diego; CHR: Clinical High Risk; CHR-NP: Clinical High Risk-Non Psychotic; CHR-P: Clinical High Risk-Psychotic; COGMAPS: Cognitively Graded Mental Health Research Institute Assessment Protocol for Schizophrenia⁷²; COWAT: Controlled Oral Word Association Test⁸⁷; CPT-IP: Continuous Performance Test, Identical Pairs version¹²⁶; CTL: Control Group; CVLT: California Verbal Learning Test¹²⁷; Dep: Depression; DR: Delayed Response (CANTAB); DMTS: Delayed Matching to Sample; FEP: First-Episode Psychosis; FEPSY: Früherkennung von Psychosen, Basel, Germany; FETZ: Früherkennungs- und Therapiezentrum für psychotische Krisen; FSIQ: Full Scale Intelligence Quotient; GAD: Generalised Anxiety Disorder; GAF: Global Assessment Form; Log Mem: Logical Memory subtest from the WMS-R⁸⁰; ms: milliseconds; N/A: Not available; NART: National Adult Reading Test¹²⁸; NOS: Not otherwise specified; NS: Non-significant; OCD: Obessessive Compulsive Disorder; PACE: Personal Assessment and Crisis Evaluation Clinic, Melbourne, Australia; PAS: Psychological Assistance Service, Newcastle, Australia; PAL: Paired Associate Learning (WMS-R); PIQ: Performance IQ (WAIS); PRIME: Prevention through Risk Identification, Management, and Education Clinic, Yale University; PTSD: Post Traumatic Stress Disorder; R: Revised; RAP: Recognition and Prevention Program, New York; RAVLT: Rey Auditory Verbal Learning Test^129,130; R/T: Reaction Time; RVP: Rapid Visual Processing (CANTAB); Scz: Schizophrenia; Schizaff: Schizo Affective Disorder; SRM: Spatial Recognition Memory (CANTAB); SS: Scaled Score; SWM: Spatial Working Memory (CANTAB); TAP: Testbattreie zur Aufmerksamkeitsprufung¹⁰³; T&S: Trait/State; Twr: Tower; UHR: Ultra-High Risk; UHR-NP: Ultra-High Risk—Nonpsychotic; UHR-P: Ultra-High Risk—Psychotic transition; UPSIT: University of Pennsylvania Smell Identification Test⁷³; Vis Rep: Visual Reproduction subtest (WMS-R); VIQ: Verbal IQ (WAIS)¹³¹; VMI: Verbal Memory Index (WMS-R); WAIS: Wechsler Adult Intelligence Scale¹³¹; WAIS-R: Wechsler Adult Intelligence Scale-Revised; WCST: Wisconsin Card Sorting Test¹⁰²; WISC: Wechsler Intelligence Scale for Children³⁶; WM: Working Memory; WMS-R: Wechsler Memory Scale—Revised⁸⁰; WRAT: Wide Range Achievement Test¹³²