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Perceptual abnormalities (PAs) such as auditory hallucinations are one of the most common symptoms of psychotic patients. However, it remains unclear whether symptoms of sub-clinical PAs also play a key role in predicting psychosis. In an ongoing prospective follow-up study of individuals at a clinical high risk (CHR) of psychosis, we evaluated the potential of first-time experience of PAs and/or thought content disorders (TCDs) to predict psychosis. Conversion to psychosis was the major focus of this follow-up study. A total of 511 CHRs were recruited, of whom 443 (86.7%) completed the clinical follow-up of at least 6 months and up to 2 years. CHRs were divided into four groups according to the presence of PAs and/or TCDs. At the follow-up endpoint, 39 (19.9%) CHRs in the “TCDs-only” group, 2 (8.3%) in the “PAs-only” group, 45 (17.0%) in the “TCDs-and-PAs” group, and 1 (3.8%) in the “None” group converted to psychosis. Survival analysis revealed a higher conversion rate in CHRs with TCDs compared with those with PAs only. CHRs with isolated PAs had shown a higher level of dysphoric mood at baseline compared with those with TCDs. About 89% TCDs contents were related with their experienced PAs. Compared with TCDs, the isolated PAs are not strongly associated with increased susceptibility to psychosis.

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Isolated hallucination is less predictive than thought disorder in psychosis: Insight from a longitudinal study in a clinical population at high risk for psychosis