CORE 4-. PRODROMAL RESEARCH PROGRAM. The primary goal ofthis Core is to provide prodromal participants with a high quality clinical care setting within which the proposed Center research can take place. The objectives are:l) recruit patients with prodromal symptoms and demographically matched controls;2) conduct diagnostic evaluations to determine study eligibility, and to coordinate subjects'participation in the four TRCBS research projects;3) sustain subjects'participation in TRCBS research projects by providing extensive case management, psychological, and (when appropriate) psychiatric services;4) conduct repeated assessments of clinical and functional status, and to assess conversion to schizophrenia or other psychotic disorders. To achieve the first objective, we will engage in community outreach and partner with community mental health sites to generate referrals of patients with prodromal symptoms. Staff will provide talks to educate local mental health programs, schools, and support groups about the psychosis prodrome and our services. To achieve the second objective, we will conduct structured interviews of established reliability and predictive validity, and continue to develop efficient screening instruments to detect prodromal symptoms. For the third objective, we will provide case management, skills training, family education, ongoing monitoring of symptoms and functioning, and, when clinically indicated, psychiatric treatment By offering ongoing evaluation and case management, we hope to detect conversion to psychosis earlier than would otherwise be typical. Earlier intervention is associated with better treatment response and long-term prognosis. To achieve the fourth objective, we will assess clinical and functional status at 6- and 12-month follow-ups, and will re-assess diagnostic status at 24 months. Each TRCBS project will evaluate a set of cognitive and/or emotional processes to determine whether baseline functioning in these systems, and deterioration over time, is associated with psychosis onset. These findings will elucidate mechanisms underlying psychosis onsetandimprove.sensitivity and specificity of prediction ofschizophrenia, so that future primary prevention efforts can be targeted to those who need it most.

Public Health Relevance

The primary goal of the Prodromal Research Program is to provide young people at clinical high-risk for psychosis wilh a high quality clinical care setting, within which the proposed longitudinal studies of cognition and emotion can lake place. These findings will help us lo understand the mechanisms leading lo the development of psychosis, and improve our abilily lo predict who is most at risk.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Specialized Center (P50)
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Special Emphasis Panel (ZMH1)
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University of California Los Angeles
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