Identification of young people at risk of psychosis: validation of Personal Assessment and Crisis Evaluation Clinic intake criteria

Objective: To describe the development and validation of the criteria used at the Personal Assessment and Crisis Evaluation (PACE) Clinic to identify young people at 'ultra-high' risk of developing a psychotic disorder within a short follow-up period. Method: The PACE Clinic criteria initially grew out of clinical observation s and retrospective research describing the prodromal phase of first-episod e psychosis. Early prospective research refined the criteria into the three intake groups for the Clinic. These criteria combine putative state and tr ait risk factors for psychosis. Whether or not a person meets criteria for one or more of these groups can usually be determined by a thorough psychol ogical assessment interview. Two early studies are described that assess th e validity of this screening protocol. Results: The transition rate to acute psychosis of the 'ultra-high' risk gr oup identified in the second study was 41%. Conclusions: These results suggest that it is possible to accurately identi fy young people at imminent risk of psychosis. The PACE criteria have now b een adopted (or adapted) by a number of other clinical research programs bo th in Australia (i.e. Psychological Assistance Service in Newcastle) and ot her programs in the United States and elsewhere. This research may lead the way to the development of preventive interventions for the ultra-high risk group.