Conditions for Further Study 785
cinatory experiences and delusional thinking. There appears to be a slight male prepon-
derance for attenuated psychosis syndrome.
Development and Course
Onset of attenuated psychosis syndrome is usually in mid-to-late adolescence or early
adulthood. It may be preceded by normal development or evidence for impaired cogni-
tion, negative symptoms, and/or impaired so cial development. In help-seeking cohorts,
approximately 18% in 1 year and 32% in 3 years may progress symptomatically and met
criteria for a psychotic disorder . In some cases, the syndrome may transition to a depres-
sive or bipolar disorder with psychotic featur es, but development to a schizophrenia spec-
trum disorder is more frequent. It appears that the diagnosis is  best applied to individuals
ages 15–35 years. Long-term course is not yet describe d beyond 7–12 years.
Risk and Prognostic Factors 
Temperamental. Factors predicting prognosis of attenuated psychosis syndrome have
not been definitively characterized, but the presence of negative symptoms, cognitive im-
pairment, and poor functionin g are associated with poor outcome and increase risk of
transition to psychosis.
Genetic and physiological. A family history of psychosis places the individual with at-
tenuated psychosis syndrome at  increased risk for developing a full psychotic disorder.
Structural, functional, and neurochemical  im aging data are associated with increased risk
of transition to psychosis.
Functional Consequences of 
Attenuated Psychosis Syndrome
Many individuals may experience functional impairments. Modest-to-moderate impair-
ment in social and role functioning may pers ist even with abatement of symptoms. A sub-
stantial portion of individuals with the diagnosis will improve over time; many continue