Distinguishing characteristics of subjects with good and poor early outcome in the Edinburgh High-Risk Study.

Background 'High-risk'studies of schizophrenia have the potential to clarify the pathogenesis of schizophrenia. Here, results of extreme outcome groups in the Edinburgh High-Risk Study are presented. Aims To compare groups of good and poor outcome from the Edinburgh High-Risk Study and clarify the nature ofthe change from the state of vulnerability to that ofdeveloping psychosis. Method The recruitment procedure is described. Good and poor outcome are defined. These groups are compared in terms of genetic liability and of baseline and change in neuropsychology and neuroanatomy. Results Demographic characteristics and genetic liability do not differ between the groups. The good outcome group perform better at baseline in some neuropsychological tests, but there is little neuroanatomical difference. The poor outcome group show consistently impaired memory function and a tendency to reduction in temporal lobe size. Conclusions In genetically predisposed subjects, the change from vulnerability to developing psychosis may be marked by a reduced size and impaired function ofthe temporal lobe. Declaration of interest This study was financed by the Medical Research Council, which supports S.M.L. and R.C.