Towards a Framework for Good Outcome in People at Clinical High Risk for Psychosis: A Delphi Consensus Study

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Outcomes in people at clinical high risk for psychosis (CHR-P) have usually been defined in terms of psychosis onset. However, within the subgroup of individuals who do not develop psychosis, some have persistent symptoms; while in others, symptoms resolve and functioning is restored. Currently, little is known about what predicts a good outcome (GO) in CHR-P individuals, partly because there is no consensus on how this should be defined.

The Delphi method was used to elicit the opinions of 46 experts to reach a consensus on factors that together could define GO in the CHR-P population. Three online surveys were implemented. The panel rated each survey item according to how important they thought it was as a measure of GO. Participants also answered open-ended questions on how GO should be determined, their responses were subject to content analysis.

Ninety-eight items were endorsed by 80% of the panel as essential or important for a GO; these fell into 4 domains: Functioning; Symptoms; Distress/Suicidality; and Subjective Wellbeing. The individual item that was rated as the most important, was daily functioning. Themes emerged from the qualitative data, which corresponded to the Delphi domains, including ‘functioning’; ‘clinical factors; and ‘user-defined outcomes’.

A GO in CHR-P subjects can be defined by using a combination of measures from domains that reflect level of functioning; symptoms; distress/suicidality; and subjective wellbeing. These results provide a basis for a standardised definition of good outcome in people at clinical high risk of psychosis.
Original languageEnglish
Pages (from-to)209-216
Number of pages8
JournalSchizophrenia Research
Publication statusPublished - 1 Jun 2019


  • Daily functioning
  • Protective factors
  • Remission
  • Subjective wellbeing
  • Support
  • User-defined outcome


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