{"doi":"10.1001/jamanetworkopen.2025.25644","title":"Incidence, Prevalence, and Stability of Remission in Individuals With Clinical High Risk for Psychosis","abstract":"Importance: While remission from clinical high risk (CHR) for psychosis is a favorable outcome, it is not well characterized over time. Objective: To examine remission incidence, prevalence, and stability, and their association with demographic, clinical, medication, and cognitive variables, comparing 2 commonly used definitions. Design, Setting, and Participants: This cohort study examined data from individuals aged 12 to 30 years at CHR in the North American Prodromal Longitudinal Study 3, collected from 9 sites across the US from February 2015 to November 2018. Statistical analyses were conducted between January 2023 and May 2025. Exposure: CHR status using 2 definitions: (1) a symptoms-only definition based on the positive symptoms from the Scale of Prodromal Symptoms and (2) a symptoms-and-function definition based on positive symptoms and the modified Global Assessment of Functioning. Main Outcomes and Measures: The primary outcomes were remission incidence, prevalence, and stability for 7 follow-up visits over 2 years. Associations of remission with age, sex at birth, race, antipsychotic and antidepressant medication, history of trauma, and cognitive performance were determined using mixed-effects logistic regression. Results: The sample included 692 individuals (mean [SD] age, 18.7 [4.1] years; 319 female [46%]) at baseline, with 614 completing at least 1 follow-up. For the symptoms-only definition, 7% (95% CI, 5%-10%) met remission criteria after 2 months, 34% (95% CI, 31%-38%) met remission criteria at least once during the study, and 26% (95% CI, 22%-29%) met criteria at their last visit. The symptoms-and-function definition was associated with a lower remission incidence and prevalence, with 4% (95%CI, 2%-5%) meeting remission criteria after 2 months, 21% (95% CI, 18%-24%) meeting criteria at least once, and 15% (95% CI, 13%-18%) meeting criteria at their last visit. Under the symptoms-only definition, 83 of 153 individuals at CHR with at least 1 follow-up after remission (54%; 95% CI, 46%-62%) were stable remitters. Under the symptoms-and-function definition, 43 of 91 individuals (47%; 95% CI, 37%-58%) were stable remitters. The chance of staying in remission rose drastically once a person had more than 1 previous recorded remission visit. Higher functioning was associated with higher likelihood of remission (current score for symptoms only: OR, 1.04; 95% CI, 1.01-1.08; current score for symptoms and function: OR, 1.08; 95% CI, 1.02-1.14). More symptoms at baseline was associated with a lower likelihood of remission (general symptoms for symptoms only: OR, 0.77; 95% CI, 0.70-0.84; general symptoms for symptoms and function: OR, 0.80; 95% CI, 0.69-0.92). Conclusions and Relevance: These findings suggest that CHR status is a dynamic state and that vulnerability can persist even after functional remission. Hence, continued follow-up and facilitated reengagement with clinical services after remission are essential.","journal":"JAMA Network Open","year":2025,"id":532743,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7945,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":342819,"name":"Grace R. 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Cho","orcid":null,"position":9,"is_corresponding":false},{"id":1178335,"name":"Eduardo Castro","orcid":"0000-0002-7788-9069","position":10,"is_corresponding":false},{"id":1035711,"name":"Anastasia Haidar","orcid":"0009-0009-8839-2232","position":11,"is_corresponding":false},{"id":411591,"name":"Jean Addington","orcid":"0000-0002-8298-0756","position":12,"is_corresponding":false},{"id":232039,"name":"Tina Kapur","orcid":"0000-0003-3646-9508","position":13,"is_corresponding":false},{"id":432469,"name":"Sylvain Bouix","orcid":"0000-0003-1326-6054","position":14,"is_corresponding":false},{"id":109354,"name":"Carrie E. Bearden","orcid":"0000-0002-8516-923X","position":15,"is_corresponding":false},{"id":343004,"name":"John M. Kane","orcid":"0000-0002-2628-9442","position":16,"is_corresponding":false},{"id":289189,"name":"Patrick D. McGorry","orcid":"0000-0002-3789-6168","position":17,"is_corresponding":false},{"id":411597,"name":"Scott W. Woods","orcid":"0000-0002-3103-5228","position":18,"is_corresponding":false},{"id":289181,"name":"Barnaby Nelson","orcid":"0000-0002-6263-2332","position":19,"is_corresponding":false},{"id":62374,"name":"René S. Kahn","orcid":"0000-0001-5909-8004","position":20,"is_corresponding":false},{"id":274933,"name":"Martha E. Shenton","orcid":"0000-0003-4235-7879","position":21,"is_corresponding":false},{"id":249475,"name":"Guillermo Cecchi","orcid":"0000-0003-1013-8348","position":22,"is_corresponding":false},{"id":311510,"name":"Ofer Pasternak","orcid":"0000-0002-7078-6446","position":23,"is_corresponding":false},{"id":687753,"name":"Johanna Seitz‐Holland","orcid":"0000-0002-1815-2681","position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":null,"created_at":"2026-07-19T02:51:27.893975Z","pmid":"40762913","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}