transition to psychosis: evaluation of the first-degree ‎relatives of patients with schizophrenia ‎

objective: schizophrenia and other psychoses have devastating personal and social impacts and many efforts have been devoted to study ‎prodromal syndromes for psychosis in order to achieve earlier detection and interventions. however, only few studies have been ‎performed in developing countries on this subject, and there is a dearth of evidence in the iranian population. in this study, we ‎focused on conversion rate to psychosis and changes in prodromal symptoms in a group of first-degree relatives of patients with ‎schizophrenia and to compare the conversion rate in those with and without prodromal symptoms as assessed by the structured ‎interview for prodromal syndromes (sips) and scale of prodromal symptoms (sops).‎‎ method: participants were the first-degree relatives of hospitalized patients with schizophrenia at roozbeh hospital, tehran, iran. at baseline, ‎a trained psychiatrist interviewed the participants using the sips and the sops and assigned them to high- or low-risk groups either ‎based on the presence of prodromal criteria or seeking mental health services. after 12 months, the same examiner re-evaluated ‎the participants in order to determine the changes in their symptoms and identify the probable transitions to psychosis.‎ results: one hundred participants, 50 participants within each of high- or low-risk groups, were recruited at baseline. eight participants ‎dropped out of the study. at the follow-up, the rate of transition to full psychosis among high-risk group was 13% (95% ci [0.029, ‎‎0.23]), whereas none of the low-risk participants developed psychosis. none of the high-risk participants demonstrated attenuation ‎in their prodromal states after a one-year follow-up. in contrast, of the 50 low-risk participants, three experienced prodromal ‎symptoms for psychosis during this period. high-risk participant’s illustrated higher severity in almost all of the sops items compared ‎to the low-risk participants at both baseline and follow-up evaluations. conclusion : prodromal syndrome for psychosis based on the sips and the sops was a predictive factor for transition to psychosis after a 12-‎month period in a group of first-degree relatives of patients with schizophrenia admitted to a psychiatric hospital in iran. conducting ‎further studies on this at-risk population is highly recommended in order to provide practical methods for early screening and ‎therapeutic interventions