Predictors of functional outcome in individuals at high clinical risk for psychosis at six years follow-up

Brandizzi, Martina; Valmaggia, Lucia; Byrne, Majella; Jones, Ceri; Iwegbu, N.; Badger, Steven; McGuire, Philip; Fusar‐Poli, Paolo

doi:10.1016/j.jpsychires.2015.03.005

Cited by 43 publications

(51 citation statements)

References 64 publications

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“…These findings add to the growing literature that poor functional and mental health outcomes occur in many UHR individuals regardless of long-term transition status (Addington et al, 2011;Brandizzi et al, 2015;Lin et al, 2011Lin et al, , 2015Yung et al, 2015). Those UHR individuals who were unemployed exhibited more severe symptoms across all measures at the follow-up assessment and were more likely to have been diagnosed with a psychotic, mood, anxiety or substance use disorder.…”

Section: Discussionmentioning

confidence: 51%

Long-term employment among people at ultra-high risk for psychosis

Cotter

Lin

Drake

et al. 2017

Schizophrenia Research

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Word count abstract: 250Word count paper: 2,894 Number of tables: 2Supplementary data: Supplementary Table 1 2 Abstract BackgroundPsychotic disorders are associated with high rates of sustained unemployment, however, little is known about the long-term employment outcome of people at ultrahigh risk (UHR) of developing psychosis. We sought to investigate the long-term unemployment rate and baseline predictors of employment status at follow-up in a large UHR cohort. Method UHR patients recruited from the Personal Assessment and Crisis Evaluationclinic in Melbourne, Australia were followed-up over 2-14 years after initial presentation to the service. Individuals in no form of employment or education were classed as unemployed. Logistic regression analyses were used to examine predictors of employment outcome. ResultsA high rate of unemployment was present at follow-up in this UHR sample (23%). At baseline, those who were unemployed at follow-up had a longer duration of untreated illness, more severe negative symptoms, lower IQ, poorer social and occupational functioning and reported more childhood trauma than the employed group. At follow-up, unemployed individuals exhibited significantly more severe symptoms on all measures and were more likely to have been diagnosed with a mood, anxiety, psychotic or substance use disorder. Childhood trauma and the duration of untreated illness at baseline were significant independent predictors of employment status at follow-up in the multivariate analyses.3 ConclusionsNearly a quarter of this UHR sample were unemployed at long-term follow-up. The duration of untreated illness and the effects of childhood trauma are potentially modifiable risk factors for long-term employment outcome in this group. Vocational support may be beneficial for many UHR patients presenting to services.

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Section: Discussionmentioning

confidence: 51%

Long-term employment among people at ultra-high risk for psychosis

Cotter

Lin

Drake

et al. 2017

Schizophrenia Research

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“…() and Brandizzi et al . () studies assessed prodromal symptoms in samples aged under 18, whereas the current study focused on a sample covering the age range at peak risk for the onset of mental health problems (14–25 years). The current sample was also recruited from a service with a specific remit to provide care for individuals with more severe presentations.…”

Section: Discussionmentioning

confidence: 99%

“…Whilst the presence of PLEs alone does not necessarily predict future transition to psychosis (Yung et al ., ), it is arguably important to assess and address such experiences where they cause distress. Indeed, individuals meeting UHR criteria but who do not convert to psychosis have been shown to have poor long‐term outcomes (Brandizzi et al ., ; Kelleher et al ., ; Lin et al ., ) and similar levels of functional impairment to those who make transition (Fusar‐Poli et al ., ). Thus, PLEs may reflect an increased clinical risk for a range of adverse outcomes, consistent with the pluripotent risk syndrome model (Yung et al ., ).…”

Section: Introductionmentioning

confidence: 99%

Clinician‐rated and self‐reported psychotic‐like experiences in individuals accessing a specialist Youth Mental Health Service

Hodgekins

Lower

Wilson

et al. 2018

British J Clinic Psychol

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Clinical Implications Psychotic-like experiences are common in young people with severe non-psychotic mental health problems and should be routinely screened in mental health services. Psychotic-like experiences were found to be more prevalent when using a self-report screening tool compared to a clinician-rated measure. The presence of psychotic-like experiences may reflect more severe and complex mental health problems and may also cause delays in young people accessing the right kind of support. ;Limitations This study only assessed the presence or absence of psychotic-like experiences. Further studies should use more detailed assessments to understand more about the nature of such experiences and how they are appraised and responded to. This study is cross-sectional, and therefore, the direction of the relationships between psychotic-like experiences and depression, anxiety, functioning, and trauma cannot be specified. Longitudinal studies are needed to examine the impact of psychotic-like experiences on long-term outcomes.

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“…Numerous studies suggest negative symptoms to be a strong symptom predictor of social and role functioning in schizophrenia (Fulford, D., et al, 2013, Ventura, J., et al, 2009). Among UHR patients, negative symptoms have consistently been associated with impaired social and role functioning (Brandizzi, M., et al, 2015, Fulford, D., et al, 2013, Kim, H.S., et al, 2011, Meyer, E.C., et al, 2014) and have been found to be predictive of transition to psychosis (Demjaha, A., et al, 2012, Valmaggia, L.R., et al, 2013). A previous study has assessed the association between social cognition, clinical symptoms, and functioning in a UHR sample, and found deficits on the ToM visual jokes task to be associated with impairments in global functioning after adjusting for negative symptoms (Cotter et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Social cognition in patients at ultra-high risk for psychosis: What is the relation to social skills and functioning?

Glenthøj

Fagerlund

Hjorthøj

et al. 2016

Schizophrenia Research: Cognition

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ObjectivePatients at ultra-high risk (UHR) for psychosis show significant impairments in functioning. It is essential to determine which factors influence functioning, as it may have implications for intervention strategies. This study examined whether social cognitive abilities and clinical symptoms are associated with functioning and social skills.MethodsThe study included 65 UHR patients and 30 healthy controls. Social cognitive function, social skills, and a broad range of functioning measures were assessed.ResultsThe UHR patients demonstrated significant decrements on The Awareness of Social Inferences Task total score (p = .046, d = .51), and on the CANTAB emotion recognition task total percent correct (p = .023, d = .54) displaying particular difficulties in negative affect recognition. The patients exhibited significant impairments in social skills measured with the High Risk Social Challenge (p˂.001, d = 1.05). Aspects of emotion recognition were associated with role functioning and social skill performance. The level of attributional bias was associated with overall functioning, and theory of mind ability was associated with self-reported functioning. Negative symptoms were associated with all measures of functioning (p ≤ .05).ConclusionSignificant impairments in social cognition and social skills were found in UHR patients. The patients' social cognitive function was associated with overall functioning and social skills. Negative symptoms appear to play an important role for functioning. Research is needed to investigate how the relations between social cognition, social skills and functioning develop from the UHR state to the stage of manifest illness. Research into how deficits in social cognition and social skills can be ameliorated in UHR patients is warranted.

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Predictors of functional outcome in individuals at high clinical risk for psychosis at six years follow-up

Cited by 43 publications

References 64 publications

Long-term employment among people at ultra-high risk for psychosis

Long-term employment among people at ultra-high risk for psychosis

Clinician‐rated and self‐reported psychotic‐like experiences in individuals accessing a specialist Youth Mental Health Service

Social cognition in patients at ultra-high risk for psychosis: What is the relation to social skills and functioning?

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