Conclusions
REMISSION
Enhancing the intensity of treatment with psychological interventions or medications was challenging to implement with fidelity and adherence in this largely primary care-based sample but nevertheless could not be demonstrated to produce any benefit over and above continuing a simpler form of care. Low remission and high relapse rates confirm the sustained vulnerability and substantial morbidity of the ultrahigh risk population and highlight the need to conduct further adaptive trials, develop new treatments, provide sustained specialist care, and identify subgroups for whom treatments can be tailored.