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Background: The accurate prediction of a transition to psychosis in high-risk and ultra-high-risk (UHR) populations is important because timely preventive interventions may succeed in delaying or even averting psychosis. However, current screening programmes have very low predictive power. Therefore, if prodromal signs are to be really useful they need to be objective and have strong predictive power. We hypothesise that in the prodromal phase movement disorders (MD) are probably better than screening programmes at predicting the development of psychotic disorders., Aim: To determine, on the basis of published articles and personal experience, whether, in UHR populations, MD can predict a transition to psychosis more accurately that current screening programmes., Method: We studied the literature using Medline., Results: Our strategy was to search the literature for studies concerning 1. children with schizotypal personality disorder, 2. UHR adolescents and 3. siblings of patients with schizophrenia. Studies relating to the first two groups showed that the severity of MD was related to the severity of the prodromal signs both at baseline and at follow-up. Patients with more (and more severe) MD had a higher risk of transition to a psychotic disorder than patients without MD. Studies relating to the third group showed that the frequency of mechanically measured md was significantly higher in the siblings of patients with schizophrenia than in healthy controls., Conclusion: MD are objective easy-to-measure prodromal signs which might be powerful predictors of a transition to psychosis in (U)HR populations.

Background: Psychotic symptoms can occur during normal development, but they can also indicate the presence of or an increased risk of a psychotic disorder. By studying children who are at risk of developing a psychotic disorder we can obtain information that will help to distinguish more accurately between developmental phenomena and psychopathology., Aim: To present the current state of our knowledge about the development of psychotic symptoms and psychotic disorders and to discuss the importance of continuing research into subpopulations of children who are at risk of developing a psychotic disorder., Method: We give an epidemiological and clinical description of psychosis in childhood and we report on recent Dutch and international studies about children with an increased risk of developing psychotic disorders., Results: Results so far indicate that these children tend to have an increased risk of developing not only psychotic disorders but also a wide range of psychopathological conditions in later life. The degree of risk depends on the nature and number of risk factors involved., Conclusion: More research is needed to follow the development of children with an increased risk of psychotic disorders.