The research on ultra-high-risk cohorts, which includes many studies featuring significant psychosocial or cognitive-behavioral treatment, indicates that between 15% and 40% of individuals convert to schizophrenia (8). Over the past 15 years, a growing effort has gone into attempting to refine the ultra-high-risk diagnosis and prevent the onset of schizophrenia in groups with high-risk symptoms (8). Nonetheless, a recent article by Addington et al. (9) in the Journal showed that over 2 years, patients who did not convert actually improved slightly without medication. These results suggest that the diagnostic validity of the ultra-high-risk syndrome is not precise enough to begin treatment with drugs that show significant metabolic side effects; in many people, drug treatment may not be necessary. What is needed is a marker that identifies people who will convert to full psychosis and in whom treatment can be expected to prevent the development of schizophrenia. The Howes et al. study, perhaps combined with anatomical regression data or EEG spectral power studies (10, 11), may present us with a reliable test battery for predicting conversion to active schizophrenia.