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Aims: Around 15% of patients at clinical high risk for psychosis (CHR‐P) experience symptomatic remission and functional recovery at follow‐up, yet the definition of a good outcome (GO) in this population requires further development. Outcomes are typically designed and rated by clinicians rather than patients, to measure adverse as opposed to GOs. Here we investigate how CHR‐P subjects define a GO, with the aim of developing a checklist that could be used to measure GO in this clinical group. Methods: A set of GO‐focused questions were designed in collaboration with a service‐user. CHR‐P patients (n = 48) were asked to rate the importance of items that could indicate short‐term (1 year) and long‐term (5 years) GO. These items were then ranked using the relative importance index (RII). Results: Patients rated improvement in subjective wellbeing (RII = 0.829) and non‐specific presenting symptoms (RII = 0.817) amongst the factors most important for indicating GO in the short‐term, and improved resilience (RII = 0.879) and negative symptoms (RII = 0.858) as key items for indicating long‐term GO. Patients regarded building resilience (RII = 0.842) and having support from mental health services (RII = 0.833) as being protective for their mental health. These measures were included in a preliminary 12‐item GO checklist (GO‐12) for assessing GO in CHR‐P subjects. Conclusions: Patient‐defined measures of GO included items that are not incorporated into conventional measures of outcomes in CHR‐P subjects, such as subjective wellbeing and resilience. Integrating patient‐defined metrics of GO may improve the assessment of outcomes in the CHR‐P population. [ABSTRACT FROM AUTHOR]

Background: Among adults with schizophrenia, evidence suggests that premorbid deficits in different cognitive domains follow distinct developmental courses during childhood and adolescence. The aim of this study was to delineate trajectories of adolescent cognitive functions prospectively among different groups of youth at‐risk for schizophrenia, relative to their typically developing (TD) peers. Method: Using linear mixed models adjusted for sex, ethnicity, parental occupation and practice effects, cognitive development between ages 9 and 16 years was compared for youth characterised by a triad of well‐replicated developmental antecedents of schizophrenia (ASz; N = 32) and youth with a least one affected relative with schizophrenia or schizoaffective disorder (FHx; N = 29), relative to TD youth (N = 45). Participants completed measures of IQ, scholastic achievement, memory and executive function at three time‐points, separated by approximately 24‐month intervals. Results: Compared to TD youth, both ASz and FHx youth displayed stable developmental deficits in verbal working memory and inhibition/switching executive functions. ASz youth additionally presented with stable deficits in measures of vocabulary (IQ), word reading, numerical operations, and category fluency executive function, and a slower rate of growth (developmental lag) on spelling from 9 to 16 years than TD peers. Conversely, faster rates of growth relative to TD peers (developmental delay) were observed on visual and verbal memory, and on category fluency executive function (ASz youth only) and on matrix reasoning (IQ) and word reading (FHx youth only). Conclusions: These differential patterns of deviation from normative adolescent cognitive development among at‐risk youth imply potential for cognitive rehabilitation targeting of specific cognitive deficits at different developmental phases. [ABSTRACT FROM AUTHOR]