Document Type

Journal Article

Publication Title

Frontiers in Psychiatry




Frontiers Media S.A.


School of Arts and Humanities


Health West Foundation Norwegian Extra Foundation for Health and Rehabilitation EXTRA funds


Joa, I., Bjornestad, J., Johannessen, J. O., Langeveld, J., Stain, H. J., Weibell, M., & Hegelstad, W. T. V. (2021). Early detection of ultra high risk for psychosis in a Norwegian catchment area: The two year follow-up of the prevention of psychosis study. Frontiers in Psychiatry, 12, article 573905.


Objectives: Most individuals experience a relatively long period of sub-clinical psychotic like symptoms, known as the ultra high risk (UHR) or at risk mental states (ARMS), prior to a first episode of psychosis. Approximately 95% of individuals who will later develop psychosis are not referred to specialized clinical services and assessed during the UHR phase. The study aimed to investigate whether a systematic early detection program, modeled after the successful early detection of psychosis program TIPS, would improve the detection of help-seeking UHR individuals. The secondary aim was to examine the rates and predictors of conversion to psychosis after 2 years. Method: The overall study design was a prospective (2012–2018), follow- up study of individuals fulfilling UHR inclusion criteria as assessed by the structural interview for prodromal syndromes (SIPS). Help-seeking UHR individuals were recruited through systematic early detection strategies in a Norwegian catchment area and treated in the public mental health services. Results: In the study period 141 UHR help-seeking individuals were identified. This averages an incidence of 7 per 100,000 people per year. The baseline assessment was completed by 99 of these and the 2 year psychosis conversion rate was 20%. A linear mixed-model regression analysis found that the significant predictors of conversion were the course of positive (0.038) and negative symptoms (0.017). Age was also a significant predictor and showed an interaction with female gender ( < 0.000). Conclusion: We managed to detect a proportion of UHR individuals in the upper range of the expected prediction by the population statistics and further case enrichment would improve this rate. Negative symptoms were significant predictors. As a risk factor for adverse functional outcomes and social marginalization, this could offer opportunities for earlier psychosocial intervention.



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This work is licensed under a Creative Commons Attribution 4.0 License.

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