Characterizing psychosis risk traits in Africa: A longitudinal study of Kenyan adolescents

Daniel Mamah, Abednego Musau, Victoria N. Mutiso, Akinkunle Owoso, Arbi Ben Abdallah, Linda B. Cottler, Catherine W. Striley, Elaine F. Walker, David M. Ndetei

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


The schizophrenia prodrome has not been extensively studied in Africa. Identification of prodromal behavioral symptoms holds promise for early intervention and prevention of disorder onset. Our goal was to investigate schizophrenia risk traits in Kenyan adolescents and identify predictors of psychosis progression. 135 high-risk (HR) and 142 low-risk (LR) adolescents were identified from among secondary school students in Machakos, Kenya, using the structured interview of psychosis-risk syndromes (SIPS) and the Washington early recognition center affectivity and psychosis (WERCAP) screen. Clinical characteristics were compared across groups, and participants followed longitudinally over 0-, 4-, 7-, 14- and 20-months. Potential predictors of psychosis conversion and severity change were studied using multiple regression analyses. More psychiatric comorbidities and increased psychosocial stress were observed in HR compared to LR participants. HR participants also had worse attention and better abstraction. The psychosis conversion rate was 3.8%, with only disorganized communication severity at baseline predicting conversion (p = 0.007). Decreasing psychotic symptom severity over the study period was observed in both HR and LR participants. ADHD, bipolar disorder, and major depression diagnoses, as well as poor occupational functioning and avolition were factors relating to lesser improvement in psychosis severity. Our results indicate that psychopathology and disability occur at relatively high rates in Kenyan HR adolescents. Few psychosis conversions may reflect an inadequate time to conversion, warranting longer follow-up studies to clarify risk predictors. Identifying disorganized communication and other risk factors could be useful for developing preventive strategies for HR youth in Kenya.

Original languageEnglish
Pages (from-to)340-348
Number of pages9
JournalSchizophrenia research
Issue number2-3
StatePublished - Oct 1 2016


  • Africa
  • Kenya
  • Prodrome
  • Psychosis
  • Risk
  • Schizophrenia


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