Premorbid adjustment, symptom development and quality of life in first episode psychosis: a systematic review and critical reappraisal

MacBeth, Angus; Gumley, Andrew

doi:10.1111/j.1600-0447.2007.01134.x

Cited by 109 publications

(81 citation statements)

References 135 publications

(228 reference statements)

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“…Childhood conduct disorder, the precursor to adult ASPD, may be a behavior pattern that contributes to impaired premorbid adjustment in areas such as academic and social functioning, which subsequently impacts on symptom severity (Macbeth & Gumley, 2008). This suggests that clients with ASPD and co-occurring disorders are an especially disadvantaged group due to the toxic conjunction of substance use problems, SMI, and illness severity.…”

Section: Discussionmentioning

confidence: 99%

Antisocial personality disorder in people with co-occurring severe mental illness and substance use disorders: clinical, functional, and family relationship correlates

et al. 2012

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Antisocial personality disorder (ASPD) is an important correlate of substance abuse severity in the addiction population and in people with co-occurring serious mental illness and addiction. Because family members often provide vital supports to relatives with co-occurring disorders, this study explored the correlates of ASPD in 103 people with co-occurring disorders (79% schizophrenia-schizoaffective, 21% bipolar disorder) in high contact with relatives participating in a family intervention study. Clients with ASPD were more likely to have bipolar disorder and to have been married, but less likely to have graduated from high school. ASPD was associated with more severe drug abuse and depression, worse functioning, and less planning-based social problem solving. The relatives of clients with ASPD also reported less planning-based problem solving, worse attitudes towards the client, and worse mental health functioning. Client ASPD was associated with less long-term exposure to family intervention. The findings suggest that clients with ASPD in addition to co-occurring disorders are a particularly disadvantaged group with greater illness severity, more impaired functioning, and more strained family relationships. These difficulties may pose special challenges to delivering family intervention for this group.

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Section: Discussionmentioning

confidence: 99%

Antisocial personality disorder in people with co-occurring severe mental illness and substance use disorders: clinical, functional, and family relationship correlates

et al. 2012

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“…As such, it appears timely to assess prospectively whether premorbid functioning is informative regarding risk of psychosis conversion (MacBeth & Gumley, 2008). To our knowledge, this is the first prospective study of premorbid functional development and prediction of psychosis in CHR individuals.…”

Section: Functioning In Clinical High-risk (Chr) Individualsmentioning

confidence: 99%

“…Studies of first- and multiple-episode psychotic disorders emphasize the prognostic importance of functioning prior to psychosis onset (Haas, & Sweeney, 1992; MacBeth, & Gumley, 2008). “Stable-poor” and “deteriorating” patterns of functioning are associated with earlier age of onset, greater severity and poorer treatment responsiveness of negative symptoms, worse social functioning, greater poverty of movement, greater deficits in verbal fluency and verbal memory, and poorer quality of life (e.g., Addington & Addington, 2005; Haas & Sweeney, 1992; Strous et al, 2004).…”

mentioning

confidence: 99%

Premorbid functional development and conversion to psychosis in clinical high-risk youths

et al. 2013

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Deterioration in premorbid functioning is a common feature of schizophrenia, but sensitivity to psychosis conversion among clinical high-risk samples has not been examined. This study evaluates premorbid functioning as a predictor of psychosis conversion among a clinical high-risk sample, controlling for effects of prior developmental periods. Participants were 270 clinical high-risk individuals in the North American Prodrome Longitudinal Study—I, 78 of whom converted to psychosis over the next 2.5 years. Social, academic, and total maladjustment in childhood, early adolescence, and late adolescence were rated using the Cannon–Spoor Premorbid Adjustment Scale. Early adolescent social dysfunction significantly predicted conversion to psychosis (hazard ratio = 1.30, p = .014), independently of childhood social maladjustment and independently of severity of most baseline positive and negative prodromal symptoms. Baseline prodromal symptoms of disorganized communication, social anhedonia, suspiciousness, and diminished ideational richness mediated this association. Early adolescent social maladjustment and baseline suspiciousness together demonstrated moderate positive predictive power (59%) and high specificity (92.1%) in predicting conversion. Deterioration of academic and total functioning, although observed, did not predict conversion to psychosis. Results indicate early adolescent social dysfunction to be an important early predictor of conversion. As such, it may be a good candidate for inclusion in prediction algorithms and could represent an advantageous target for early intervention.

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“…In order to develop better and more specific treatments researchers and clinicians focus on identifying factors associated with long-term disability that can be assessed already at the initial treatment contact (Kirkpatrick et al, 2006). Studies of patients coming into treatment for their first episode of psychosis show that severity of psychotic symptoms at first treatment contact as well as diagnosis has a relatively weak association with poor psychosocial functioning (from now called “functioning”) and is a poor predictor of future disability, while negative symptoms (Pogue-Geile and Harrow, 1985; White et al, 2009), male gender (Cotton et al, 2009), poor premorbid adjustment (Gonzalez-Ortega et al, 2013; MacBeth and Gumley, 2008; White et al, 2009), long duration of untreated psychosis (DUP) (Marshall et al, 2005; White et al, 2009), and cognitive dysfunction (Carlsson et al, 2006; Gonzalez-Blanch et al, 2010; Malla et al, 2002b) have been identified as stronger predictors.…”

Section: Introductionmentioning

confidence: 99%

Apathy, poor verbal memory and male gender predict lower psychosocial functioning one year after the first treatment of psychosis

Færden¹,

Barrett²,

Nesvåg³

et al. 2013

Psychiatry Research

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Background Apathy is a negative symptom associated with poor psychosocial functioning in schizophrenia but has not been sufficiently studied as predictor of poor functioning in first episode psychosis (FEP). Objective The main aim of the current study was to evaluate if apathy predicts poor functioning after 1 year in FEP patients in the context of other clinical variables with influence on outcome. Method Sixty-four FEP patients completed an extensive clinical and neuro-psychological test battery at baseline and 1-year follow-up. Symptoms were assessed with the Positive and Negative Syndrome scale (PANSS), apathy with the shortened Apathy Evaluation Scale (AES-C-12) and psychosocial functioning with the functioning score from the split version of the Global Assessment of Functioning scale (GAF-F). Results High levels of apathy, poor verbal memory and being male were the baseline variables that best predicted poor functioning at 1-year follow-up, explaining 34% of the variance in GAF-F. When PANSS negative factor was included in the analysis, the significance of AES-C-12 diminished. Conclusion These findings points to a robust role for apathy among the negative symptoms in the development of persisting psychosocial dysfunction in FEP and supports the current effort in targeting motivation to improve functioning.

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Premorbid adjustment, symptom development and quality of life in first episode psychosis: a systematic review and critical reappraisal

Cited by 109 publications

References 135 publications

Antisocial personality disorder in people with co-occurring severe mental illness and substance use disorders: clinical, functional, and family relationship correlates

Antisocial personality disorder in people with co-occurring severe mental illness and substance use disorders: clinical, functional, and family relationship correlates

Premorbid functional development and conversion to psychosis in clinical high-risk youths

Apathy, poor verbal memory and male gender predict lower psychosocial functioning one year after the first treatment of psychosis

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