The North American Prodrome Longitudinal Study is a consortium of 8 academic centers (all but one in the U.S.) seeking to develop predictors of the devel- opment of psychosis in young patients who present with prodromal symptoms. Using the Structured Interview for Prodromal Syndromes (SIPS), researchers identified 291 subjects who met criteria for a “pro- dromal syndrome.” Most of the subjects meeting the prodromal critiera had “attenuat- ed positive symptoms.” Psychotic symptoms were defined as “attenuated” when patients were not completely convinced of the veracity of their delusions or hallucinations. The researchers then followed prodromal subjects for 2 1⁄2 years to see who would develop full-blown psychosis. The overall risk for conversion to psychosis over this time period was 35%. The investigators scanned their data in search of factors that were predictive. The most accurate predic- tions (74-81%) occurred when combining three factors: genetic risk for schizophrenia plus recent functional decline, unusual thought content, and either suspicion/paranoia or impaired social functioning (Cannon TD et al., Arch Gen Psychiatry 2008;65(1):28-37).