Aim of project - The aim of the project is to map the structural MRI correlates of the transition to psychosis.

This project is part of the Dutch Prediction of Psychosis Study (DUPS). DUPS itself is part of the European Prediction of Psychosis Study (EPOS), a European multi-center joint medico-social health care systems research venture. The major focus of EPOS is to predict the transition from prodrome to psychosis. The DUPS-project is a collaboration of the Academic Medical Center in Amsterdam and the University Medical Center Utrecht (UMC). The main objectives of EPOS and DUPS are:

• Pathways to care: The description of the ways subjects at risk for psychosis get access to the health care system and the detection of obstacles to adequate treatment
• Prediction: the systematic multi-level assessment of indicators for the risk of transition to psychosis in prodromal cases and the evaluation of the predictive validity of these variables
• Disability: the description of disabilities, deficits and needs in prodromal individuals
• Intervention: the description of the therapeutic and preventive interventions applied to prodromal individuals

While the same fundamental principles (e.g. inclusion criteria) are applied in all centers, additional instruments or paradigms are added in the separate centers according to specific interests, expertise and setting. Our specific interest is in the social cognition and social functioning of prepsychotic individuals. Therefore, in addition to the subjects that are putatively prodromal according to the EPOS inclusion/exclusion criteria we are including another group of subjects that is at presumed elevated risk for psychosis, namely subjects who have a Multiple Complex Developmental Disorder (MCDD) a subtype of pervasive developmental disorders.

The study is a prospective longitudinal field-study with repeated measures to monitor subjects at high risk for psychosis. Assessment includes: basic clinical assessment, neuropsychological measures (attention, memory, executive functioning), social cognitive measures (visual social information processing, mentalizing, social attribution), school report of social and emotional behavior, neurophysiology (EEG and ERP) and structural MRI. Some data will be collected retrospectively upon inclusion into the study, for example symptom history and pathways to care. Outcome is assessed at 9, 18 and 24 months.