Premorbid adjustment associates with cognitive and functional deficits in individuals at ultra-high risk of psychosis

Lundsgaard, Julie; Kristensen, Tina Dam; Wenneberg, Christina; Gregersen, Maja; Nordentoft, Merete; Glenthøj, Louise Birkedal

doi:10.1038/s41537-022-00285-1

Cited by 3 publications

(2 citation statements)

References 82 publications

(98 reference statements)

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“…In addition, poor social relations might persist at post‐illness onset as schizophrenia studies report (del Rey‐Mejías et al, 2015; Malla et al, 2002). This is supported by our previous study finding poor PA to relate to associations between premorbid adjustment and global functioning, social functioning, and quality of life impairments (Lundsgaard et al, 2022).…”

Section: Discussionsupporting

confidence: 80%

Premorbid functioning in adolescence associates with comorbid disorders in individuals at ultra‐high risk for psychosis: A brief report

Lundsgaard

Kristensen

Nordentoft

et al. 2023

Early Intervention Psych

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Section: Discussionsupporting

confidence: 80%

Premorbid functioning in adolescence associates with comorbid disorders in individuals at ultra‐high risk for psychosis: A brief report

Lundsgaard

Kristensen

Nordentoft

et al. 2023

Early Intervention Psych

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“…These results are in line with previous studies, as better premorbid adjustment prior to the FEP onset has often been associated with recovery [ 50 , 54 , 55 , 59 , 60 ], and is a PF against poor outcomes. Early intervention preventive approaches are necessary, focusing on the premorbid period in childhood and adolescence as being a time where neurodevelopmental vulnerability is perceptible and the psychosocial and pharmacological treatments are effective [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

Risk and protective factors for recovery at 3-year follow-up after first-episode psychosis onset: a multivariate outcome approach

Serra-Arumí,

Golay,

Bonnarel

et al. 2023

Soc Psychiatry Psychiatr Epidemiol

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Purpose Recovery in people with first-episode psychosis (FEP) remains a major issue. When risk factors are studied in relation to the disorder, potential protective factors should also be considered since they can modulate this relationship. This study is aimed at exploring which premorbid and baseline characteristics are associated with a good and poor global recovery in patients with FEP at 3-year follow-up. Methods We categorized patients’ outcome by using a Latent Class Analysis (LCA) considering a multimodal set of symptomatic and functional outcomes. A Mixed effects Models Repeated Measures analysis of variance (MMRM) was used to highlight group differences over time on symptomatic and functional outcomes assessed during the 3-year follow-up. Results A total of 325 patients with FEP aged between 18 and 35 years were included. Two groups were identified. A total of 187 patients (57.5%) did not achieve recovery, and 138 patients (42.5%) achieved recovery. Recovered patients had generally a better premorbid and baseline profile in comparison with non-recovered patients (as among which shorter duration of untreated psychosis (DUP), higher degree of insight, better functional level and lower illness severity at baseline). The trajectories for the psychopathological and functional outcomes over 36 months differed between the non-recovered and the recovered group of patients. Conclusions Our results pointed to some variables associated with recovery, acting as potential protective factors. These should be considered for early intervention programs to promote psychological resilience specifically in those with a worse prognosis in order to mitigate the effects of the variables that make them more vulnerable to poorer outcome.

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Life-course perspective on the causal mechanism of social functioning in schizophrenia spectrum disorder

Osicka,

Hao,

Tiles-Sar

et al. 2024

Int J Soc Psychiatry

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Background: Due to prior emphasis on clinical recovery in Schizophrenia Spectrum Disorder (SSD), improving social functioning (SF) was oftentimes neglected, with ⩽15% of patients achieving social recovery. Priorly, we and others have shown that life-course factors, including childhood adversities, play a role in the occurrence and severity of postmorbid SF impairments, highlighting the need to understand these factors for effective interventions. Aim: This study investigates the mechanisms influencing SF in SSD and examines the causal roles of childhood trauma, premorbid adjustment, perceived stigma, self-esteem, and quality of life. Methods: This longitudinal study utilized data of 1,057 SSD patients, with measures at baseline, 3 and 6-year follow-up, from the Genetic Risk and Outcome of Psychosis cohort, to unravel the causal mechanism underlying SF utilizing Structural Equation Modeling. Determinants were assessed using validated retrospective and self-report questionnaires. Model development and testing involved a multistage process, encompassing relationships exploration, fit evaluation and model comparison. Results: We developed a probable causal model. Impaired premorbid adjustment emerged as a crucial factor, exerting negative influence on long-term SF, with a direct effect of β = −.252, p < .001 on SF at 3-year follow-up and β = −.056, p = .073 at 6-year follow-up. Childhood trauma exhibited a negative direct effect on SF at 3-year follow-up (β = −.087, p = .039), while demonstrating a substantial carry-over, indirect effect. Elevated perceived stigma negatively affected SF at 3-year follow-up (β = −.112, p = .008). The model explained 9.9% of SF variation at the 3-year follow-up and 54.3% at the 6-year follow-up. Conclusions: While validation is necessary, we found a foundational basis for causal interpretation. Premorbid adjustment, childhood trauma, and perceived stigma are essential life-course factors shaping postmorbid SF in SSD. We recommend interventions covering both prevention and treatment for individuals with established symptoms—addressing childhood trauma, premorbid adjustment, and perceived stigma—to enhance long-term social outcomes and offer actionable insights for clinicians.

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Premorbid adjustment associates with cognitive and functional deficits in individuals at ultra-high risk of psychosis

Cited by 3 publications

References 82 publications

Premorbid functioning in adolescence associates with comorbid disorders in individuals at ultra‐high risk for psychosis: A brief report

Premorbid functioning in adolescence associates with comorbid disorders in individuals at ultra‐high risk for psychosis: A brief report

Risk and protective factors for recovery at 3-year follow-up after first-episode psychosis onset: a multivariate outcome approach

Life-course perspective on the causal mechanism of social functioning in schizophrenia spectrum disorder

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