Table 1.

Ultra-High-Risk Intake and Exit Criteria

Intake criteriaGroup 1: Attenuated psychotic symptoms Presence of at least one of the following symptoms: ideas of reference, odd beliefs or magical thinking, perceptual disturbance, paranoid ideation, odd thinking and speech, odd behavior and appearance (2–3 on Unusual Thought Content scale; 1–2 on Hallucinations scale; 2–3 on Suspiciousness scale or 1–3 on Conceptual Disorganization scale of BPRS) Held with a reasonable degree of conviction, as defined by a score of 2 on the Comprehensive Assessment of Symptoms and History (CASH) rating scale for delusions Frequency of symptoms: at least several times per week Change in mental state present for at least one week and not longer than 5 years Group 2: Brief limited intermittent psychotic symptoms (BLIPS) Transient psychotic symptoms: presence of at least one of the following – ideas of reference, magical thinking, perceptual disturbance, paranoid ideation, odd thinking and speech (4+ on Unusual Thought Content scale; 3+ on Hallucinations scale; 4+ on Suspiciousness scale [or it is held with strong conviction, as defined by a score of 3 or more on the CASH rating scale for delusions] or 4+ on Conceptual Disorganization scale of BPRS) Duration of episode of less than one week Symptoms resolve spontaneously The BLIP must have occurred within the past year Group 3: Trait and state risk factors First-degree relative with a DSM-IV psychotic disorder or schizotypal personality disorder (as defined by DSM-IV) Significant decrease in mental state or functioning: maintained for at least a month and not longer than 5 years (reduction in GAF scale of 30 points from premorbid level) The decrease in functioning occurred within the past year Exit criteria: Acute psychosis Presence of at least one of the following symptoms: hallucinations (defined by a score of 3 or more on the Hallucinations scale of the BPRS); delusions (defined by a score of 4 or more on the Unusual Thought Content scale of the BPRS or a score of 4 or more on the Suspiciousness scale of the BPRS, or it is held with strong conviction, as defined by a score of 3 or more on the CASH rating scale for delusions or formal thought disorder [defined by a score of 4 or more on the Conceptual Disorganization scale BPRS]) Frequency of symptoms is at least several times a week Duration of mental state change is longer than one week

BPRS=brief psychiatric rating scale; CASH=comprehensive assessment of symptoms and history; GAF=global assessment of function scale. These are the criteria for identifying people as high risk for psychosis. People are included if they meet criteria for one or more of the three groups.