Remission Rate by Follow-up Duration and Remission Definition in CHR-P Cohorts

confidence: high · 1 sources

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Working research — not a recommendation.

This page records what the evidence says a policy does, not what anyone should do about it. It has been synthesized from the cited sources but has not been independently reviewed.

What the evidence says

All the evidence here comes from one cohort report: Seitz-Holland (2025), JAMA Network Open. It measures remission in people at clinical high risk for psychosis (CHR-P) under two definitions. The symptoms-only definition counts remission on symptoms alone. The symptoms-and-function definition also requires adequate functioning. The choice of definition changes the measured rate at every follow-up length.

At 2 months, 7% of 614 participants with at least 1 follow-up met the symptoms-only criteria (95% CI, 5%-10%). Under symptoms-and-function, 4% did (95% CI, 2%-5%). Over 24 months, 34% were in remission at least once under symptoms-only (95% CI, 31%-38%). Under symptoms-and-function, 21% were (95% CI, 18%-24%). The symptoms-and-function definition gives the lower rate at both horizons.

Remission prevalence rises with follow-up time under both definitions. By month 24 it reached 30% for symptoms-only (95% CI, 25%-35%) and 18% for symptoms-and-function (95% CI, 14%-23%). Standardized incidence per visit stayed in a narrow band: 5%-9% for symptoms-only and 3%-7% for symptoms-and-function. The report does not state the mechanism. The numbers fit new remissions accumulating at a steady per-visit rate, but the sources do not test that.

Remission often does not last. Among individuals with at least 1 follow-up after remission, 83 of 153 (54%; 95% CI, 46%-62%) were stable remitters under symptoms-only. Under symptoms-and-function, 43 of 91 (47%; 95% CI, 37%-58%) were. The claims do not give the definition of "stable remitter" beyond the study's final visit.

Baseline characteristics are associated with remission, but the evidence is associational. Higher current functioning goes with higher odds of remission. The odds ratio per unit GAF increase is 1.04 for symptoms-only (95% CI 1.01-1.08) and 1.08 for symptoms-and-function (95% CI 1.02-1.14). More baseline general symptoms go with lower odds. The odds ratio per symptom score point is 0.77 for symptoms-only (95% CI 0.70-0.84) and 0.80 for symptoms-and-function (95% CI 0.69-0.92).

The evidence is thin in breadth. It covers one cohort, and the sources here include no replication in another CHR-P sample and no follow-up past 24 months. The claims also include no remission figures from a different definition family.

Where the evidence splits

No contradictions in the current sources.

Thresholds and dose-response

One dose-response pattern is stated. The probability of remission at a visit rises with the number of prior remission visits. Under symptoms-only, it is 9% with 0 prior remission visits, 59% with 1, 72% with 2, and 87% with 3 or more. Under symptoms-and-function, it is 5%, 47%, 81% and 92% for the same counts. The step from 0 to 1 prior visit is the largest. The sources do not say whether prior remission causes later stability or whether more stable cases simply remit repeatedly. No other threshold is established in the current sources.

Open empirical questions

Findings

The symptoms-and-function definition yields lower remission rates than the symptoms-only definition at 2 months and over 24 months

confidence — direction: highconfidence — magnitude: highconsensus: thin — the only source in this set, and its direction is consistent across all three measures
mechanism
The symptoms-and-function definition adds a functioning requirement to the symptoms criteria, so fewer participants qualify.
effect
At 2 months, 4% vs 7% remission (18 vs 36 of 614). Ever remitted over 24 months: 21% vs 34% (130 vs 211 of 614). Prevalence at month 24: 18% vs 30%.
conditions / moderators
One cohort, with participants who had at least 1 follow-up. Whether the confidence intervals hold in other cohorts is not established.

Remission prevalence increases from month 2 to month 24 under both definitions

confidence — direction: highconfidence — magnitude: highconsensus: thin — a single cohort
mechanism
Not established. Per-visit incidence stays roughly constant, so new remissions accumulate over time.
effect
Symptoms-only rises from 7% to 30%. Symptoms-and-function rises from 4% to 18%.
conditions / moderators
Whether the same trajectory appears in other cohorts, and whether it reflects true remission or definition effects, is not established.

Standardized remission incidence shows no measured change across follow-up visits

confidence — direction: highconfidence — magnitude: mediumconsensus: thin — a single cohort
mechanism
Not established.
effect
Incidence stayed at 5%-9% per visit for symptoms-only and 3%-7% for symptoms-and-function.
conditions / moderators
Sample size at each visit, and whether the pattern holds beyond 24 months, are not established.

About half of remitters are stable remitters, and fewer under the symptoms-and-function definition

confidence — direction: highconfidence — magnitude: highconsensus: thin — a single cohort
mechanism
Not established.
effect
54% (83 of 153) were stable remitters under symptoms-only. 47% (43 of 91) were under symptoms-and-function. The denominator is individuals with at least 1 follow-up after remission.
conditions / moderators
The definition of "stable remitter" and whether other cohorts show similar rates are not established. The confidence intervals overlap (46%-62% vs 37%-58%).

Each additional prior remission visit increases the probability of remission at a later visit

confidence — direction: highconfidence — magnitude: highconsensus: thin — a single cohort
mechanism
Not established. The source leaves open whether prior remission itself improves stability or reflects selection of more stable cases.
effect
Symptoms-only: 9%, 59%, 72%, 87% with 0, 1, 2, 3 or more prior remission visits. Symptoms-and-function: 5%, 47%, 81%, 92%.
conditions / moderators
Associational. The causal direction is not established.

Higher current functioning is associated with higher odds of remission

confidence — direction: highconfidence — magnitude: mediumconsensus: thin — a single cohort
mechanism
Not established. The source notes that symptoms and functioning may be correlated outcomes, so the association may not be causal.
effect
Odds ratio per unit GAF increase: 1.04 (95% CI 1.01-1.08) for symptoms-only. 1.08 (95% CI 1.02-1.14) for symptoms-and-function.
conditions / moderators
Associational, in one cohort.

More baseline general symptoms are associated with lower odds of remission

confidence — direction: highconfidence — magnitude: mediumconsensus: thin — a single cohort
mechanism
Not established. The source flags possible regression to the mean and leaves open whether baseline severity predicts the remission trajectory.
effect
Odds ratio per symptom score point (general SIPS symptoms): 0.77 (95% CI 0.70-0.84) for symptoms-only. 0.80 (95% CI 0.69-0.92) for symptoms-and-function.
conditions / moderators
Associational, in one cohort.