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North American Prodrome Longitudinal Study (NAPLS 2): The Prodromal Symptoms

Addington, Jean PhD*; Liu, Lu MSc*; Buchy, Lisa PhD*; Cadenhead, Kristin S. MD; Cannon, Tyrone D. PhD; Cornblatt, Barbara A. PhD§; Perkins, Diana O. MD; Seidman, Larry J. PhD; Tsuang, Ming T. MD, PhD; Walker, Elaine F. PhD#; Woods, Scott W. MD**; Bearden, Carrie E. PhD††; Mathalon, Daniel H. MD, PhD‡‡; McGlashan, Thomas H. MD**

The Journal of Nervous and Mental Disease: May 2015 - Volume 203 - Issue 5 - p 328–335
doi: 10.1097/NMD.0000000000000290
Original Articles

In studies describing the long-term follow-up up of youth at clinical high risk (CHR) of psychosis, little attention has been given to details of specific prodromal symptoms. In this paper, we describe the prodromal symptoms of 764 CHR participants recruited in the multi-site North American Prodrome Longitudinal Study (NAPLS). Symptoms were rated on the Scale of Prodromal Symptoms (SOPS) at baseline and 6-, 12-, 18-, and 24-month follow-ups. Clinical outcome at the 2-year assessment was categorized as psychotic, prodromal progression, symptomatic or in remission. Most of the CHR sample (92%) met criteria for the attenuated positive symptoms syndrome (APSS). Significant improvements in SOPS symptoms were observed over time. Unusual thought content, disorganized communication, and overall ratings on disorganized symptoms differentiated those who transitioned to psychosis from the other clinical outcome groups. Suspiciousness and total positive symptoms differentiated those in remission from the other clinical outcome groups.

*Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada; †Department of Psychiatry, UCSD, La Jolla, CA; ‡Department of Psychology, Yale University, New Haven, CT; §Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY; ∥Department of Psychiatry, University of North Carolina, Chapel Hill, NC; ¶Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA; #Departments of Psychology and Psychiatry, Emory University, Atlanta, GA; **Department of Psychiatry, Yale University, New Haven, CT; ††Departments of Psychiatry and Biobehavioral Sciences and Psychology, UCLA, Los Angeles; and ‡‡Department of Psychiatry, UCSF, and SFVA Medical Center, San Francisco, CA.

This study was supported by the National Institute of Mental Health (grant U01MH081984 to Dr Addington; grants U01 MH081928; P50 MH080272; Commonwealth of Massachusetts SCDMH82101008006 to Dr Seidman; grants R01 MH60720, U01 MH082022, and K24 MH76191 to Dr Cadenhead; grant U01MH081902 to Dr Cannon; P50 MH066286 (Prodromal Core) to Dr Bearden; grant U01MH082004 to Dr Perkins; grant U01MH081988 to Dr Walker; grant U01MH082022 to Dr Woods; and UO1 MH081857-05 grant to Dr Cornblatt. The NIMH had no further role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

Send reprint requests to Jean Addington, PhD, Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, Canada T2N 4Z6. E-mail:

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