Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Randomised Clinical Trial Examining Cognitive Remediation Plus Standard Treatment Versus Standard Treatment in Participants at Ultra-High Risk of Psychosis. - Effect on Cognitive Functioning, Functional Outcome and Symptomatology.
Brief Summary: Cognitive deficits are known to be a core feature of schizophrenia and seem to become manifest in the prodromal or Ultra-High Risk (UHR) state of psychosis. The cognitive deficits are known to pose a critical barrier to functional recovery. Hence it is of vital importance to find intervention strategies that can alleviate these cognitive deficits and consequently improve daily functioning, and quality of life, as well as the prognosis for UHR-patients. The investigators will examine whether:

* Cognitive remediation therapy will be superior to standard treatment in improving cognitive functioning in UHR- patients (null hypothesis: No difference between the two groups).
* Cognitive remediation therapy will be superior to standard treatment in improving psychosocial functioning and clinical symptoms in UHR-patients (null hypothesis: No difference between the two groups).


Options:
A: Inclusion Criteria:

* Age between 12 years, 0 months and 35 years, 11 months
* Speaks and writes English
* Availability of at least one family member for treatment
* Meets criteria for one of three prodromal syndromes as assessed by the

Structured Interview for Prodromal Syndromes:

1. attenuated positive symptoms that are sub-psychotic in duration and intensity and have begun or worsened in the past year;
2. brief intermittent psychosis, defined as or syndromal psychotic symptoms that are have been present intermittently with onset in the previous 3 months; or
3. genetic risk and deterioration, defined as a diagnosis of schizotypal personality disorder or having a first degree relative with a psychotic disorder, plus having experienced a substantial decline (30% or greater) in Global Assessment of Functioning scores in the last year.

Exclusion Criteria:

* Diagnosis of schizophrenia or schizoaffective disorder
* Pervasive developmental disorders
* Current substance or alcohol dependence
* Neurological disorders
B: Inclusion Criteria:

* age 14-35
* meets SIPS criteria for psychosis prodrome

Exclusion Criteria:

* current antipsychotic medication
* more than 4 weeks of antipsychotic medication lifetime
C: Inclusion Criteria:

1. /written informed consent (for individuals under 18 written informed consent of at least one of the parents is required),
2. /age between 13 and 25 years,
3. /ARMS as classified by the PACE criteria (Yung et al., 1998)

PACE criteria for ARMS include one or more of following characteristics which must have occurred within the last 12 months:

* Frank psychotic symptoms \< 1 week (Transient psychosis group)
* Attenuated psychotic symptoms \> 1 week, \> 2 times per week
* Decline in global function (drop in GAF of \> 30%) plus family history of psychosis or individual has schizotypal personality disorder To operationalize PACE criteria duration and severity ratings of psychotic symptoms will be performed using the Positive and Negative Syndromes of Schizophrenia Scale (PANSS) (Kay et al., 1987) applying following cut-off scores, following Morrison et al (2002): Ad 1) Transient psychosis is defined with the presence of symptoms that score 4 or more on hallucinations, 4 or more on delusions, or 5 or more on conceptual disorganizations, last less than one week and resolve without antipsychotic medication. Ad 2) Attenuated psychotic symptoms are defined by the presence of symptoms that score 3 on delusions, 2-3 on hallucinations, 3-4 on suspiciousness or 3-4 on conceptual disorganization.

Exclusion Criteria:

1. /Acute suicidal behaviour, aggressive behaviour (PANSS hostility, suicidality = 7),
2. /Drug abuse that contributed decisively to the presentation of the index episode, (dependency on morphine, cocaine, amphetamine, but not THC),
3. /Alcohol abuse if considered as major problem,
4. /Epilepsy,
5. /Mental Retardation (IQ\<80),
6. /Pregnancy and lactation,
7. /Structural changes in MRI or CT scan (e.g., tumours), expect for enlargement of ventricles or sulci,
8. /Previous history of antipsychotic drug (\>1 week) or mood stabilizer treatment,
9. /Laboratory values more than 10% outside the normal range for transaminases, CRP or bleeding parameters,
10. /Individuals with organic brain syndrome,
11. /Individuals who are taking anticoagulants,
12. /Individuals who are taking omega 3 supplements, currently or within 8 weeks of being included in the trial,
13. /Individuals who have other, severe, intercurrent illness which in the opinion of the investigator may put them at risk or influence the results of the trial or affect ability to take part in the trial.
D: Inclusion Criteria:

* Age 18-40 yrs.
* Fulfill criteria for being at Ultra-High Risk of psychosis (defined by one or more of the following):

  * Vulnerability (Trait and State Risk Factor) Group: Individuals with a combination of a trait risk factor (schizotypal personality disorder or a family history of psychotic disorder in a first degree relative) and a significant deterioration in functioning, or sustained low functioning during the past year.
  * Attenuated Psychotic Symptoms (APS) Group: Individuals with sub-threshold (intensity or frequency) positive psychotic symptoms. The symptoms must have been present during the past year.
  * Brief Limited Intermittent Psychotic Symptoms Group (BLIPS): Individuals with a recent history of frank psychotic symptoms that resolved spontaneously (without antipsychotic medication) within one week. The symptoms must have been present during the past year.
* Provided informed consent.

Exclusion Criteria:

* Past history of a treated or untreated psychotic episode of one week's duration or longer
* Psychiatric symptoms that are explained by a physical illness with psychotropic effect or acute intoxication (e.g., cannabis use).
* Diagnosis of a serious developmental disorder, e.g,. Asperger's syndrome
* Currently receiving treatment with metylphenidate.
* Rejects providing informed consent.

Answer: D