Deconstructing Vulnerability for Psychosis: Meta-Analysis of Environmental Risk Factors for Psychosis in Subjects at Ultra High-Risk

Aim Quality of life (QoL) and social functioning have emerged as good predictors of the outcome of psychotic disorders. Poor QoL and social functioning are usually present before the onset of the first episode of psychosis. Our study aimed to explore the relationship between social adaptation and QoL in young people at risk of psychosis (ultra‐high‐risk, UHR) and healthy controls (HCs), and to investigate potential mediating effects of stress measures (perceived stress, stressful life events). Methods The study included 55 UHR subjects and 40 HC. Social functioning was assessed with the Social Adaptation Self‐evaluation Scale (SASS). Stress measures included the assessment of stressful life events and perceived stress. We compared stress and QoL measures between UHR and HC, and also compared UHR with low or normal social adaptation. A mediation analysis was performed to explore whether stress measures mediated the relationship between social adaptation and QoL. Results UHR were less frequently employed and reported more stress, poorer QoL and lower social adaptation than HC. QoL and social adaptation were associated with stress measures. UHR with low social adaptation reported more perceived stress and less QoL than UHR with normal social adaptation and HC. Perceived stress mediated the relationship between social adaptation and QoL. Conclusions Social adaptation is less developed in UHR subjects than in healthy subjects and has a negative impact on quality of life. This association is mediated by perceived stress.

Section: Discussionsupporting

confidence: 92%

Perceived stress mediates the relationship between social adaptation and quality of life in individuals at ultra high risk of psychosis

Ortega

Montalvo

Monseny

et al. 2019

“…Current literature and reviews (Fusar‐Poli et al, ; Gibson, Alloy, & Ellman, ) have shown trauma to be an important risk factor among those at high risk of psychosis. Interestingly, although our sample all met criteria for being at CHR, we found a further distinction between those with and without a family history.…”

Section: Discussionmentioning

confidence: 99%

The role of a family history of psychosis for youth at clinical high risk of psychosis

Georgopoulos

Stowkowy

Liu

et al. 2017

“…A high prevalence of trauma has consistently been reported in UHR samples (Addington et al, ; Bechdolf et al, ; Fusar‐Poli et al, ; Kraan, Velthorst, Smit, de Haan, & van der Gaag, ). Russo et al () found that those at high risk for psychosis experienced trauma at an earlier age, and a greater number of total traumas, compared to healthy controls.…”

Section: Introductionmentioning

confidence: 87%

The association between specific types of childhood adversity and attenuated psychotic symptoms in a community sample

Mongan

Shannon

Hanna

et al. 2017