M Brandizzi1, L Valmaggia2, M Byrne3, C Jones3, N Iwegbu4, S Badger4, P McGuire5, P Fusar-Poli5. 1. King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, via di Grottarossa 1035, Rome, Italy. 2. King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; OASIS Team, South London and the Maudsley NHS Foundation Trust, London, United Kingdom. Electronic address: lucia.valmaggia@kcl.ac.uk. 3. King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom. 4. OASIS Team, South London and the Maudsley NHS Foundation Trust, London, United Kingdom. 5. King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; OASIS Team, South London and the Maudsley NHS Foundation Trust, London, United Kingdom.
Abstract
BACKGROUND: The long-term functional status of subjects at ultra high risk for psychosis (HR) is relatively under investigated. This study explores baseline predictors of long-term functional outcome in HR subjects who did not convert to psychosis during a 6 years follow-up period. METHODS: A total of 154 HR were followed up for an average of 6 years. The primary outcome variable was global assessment of functioning at the last follow-up visit as assessed with the Global Assessment of Functioning tool. A multinomial logistic regression was performed to identify potential predictors of functional outcome. RESULTS: Baseline and follow-up data on functioning was available for 92 HR. Twenty-four (43%) individuals who did not convert to psychosis reported poor functioning at follow-up. Baseline scores in the GAF (Exp(b) = 0.857; 95% CIs: 0.75/0.97), employment status (Exp(b) = 0.029; 95% CIs: 0.00/0.268), and CAARMS total scores (Exp(b) = 1.976; 95% CIs: 1.00/1.14) predicted functional outcome in HR subjects at 6 years. CONCLUSIONS: Despite the preventive treatments received, many individuals who did not convert to full-blown psychosis in the longer term do not functionally remit. These individuals are lower functioning, unemployed and have higher symptom loading at the time of their presentation to the prodromal clinic. Our study suggests the need for innovative treatments targeting long term functional status beyond the prevention of psychosis onset in the HR population.
BACKGROUND: The long-term functional status of subjects at ultra high risk for psychosis (HR) is relatively under investigated. This study explores baseline predictors of long-term functional outcome in HR subjects who did not convert to psychosis during a 6 years follow-up period. METHODS: A total of 154 HR were followed up for an average of 6 years. The primary outcome variable was global assessment of functioning at the last follow-up visit as assessed with the Global Assessment of Functioning tool. A multinomial logistic regression was performed to identify potential predictors of functional outcome. RESULTS: Baseline and follow-up data on functioning was available for 92 HR. Twenty-four (43%) individuals who did not convert to psychosis reported poor functioning at follow-up. Baseline scores in the GAF (Exp(b) = 0.857; 95% CIs: 0.75/0.97), employment status (Exp(b) = 0.029; 95% CIs: 0.00/0.268), and CAARMS total scores (Exp(b) = 1.976; 95% CIs: 1.00/1.14) predicted functional outcome in HR subjects at 6 years. CONCLUSIONS: Despite the preventive treatments received, many individuals who did not convert to full-blown psychosis in the longer term do not functionally remit. These individuals are lower functioning, unemployed and have higher symptom loading at the time of their presentation to the prodromal clinic. Our study suggests the need for innovative treatments targeting long term functional status beyond the prevention of psychosis onset in the HR population.
Authors: Renate L E P Reniers; Ashleigh Lin; Alison R Yung; Nikolaos Koutsouleris; Barnaby Nelson; Vanessa L Cropley; Dennis Velakoulis; Patrick D McGorry; Christos Pantelis; Stephen J Wood Journal: Schizophr Bull Date: 2017-03-01 Impact factor: 9.306
Authors: Dana M Allswede; Jean Addington; Carrie E Bearden; Kristin S Cadenhead; Barbara A Cornblatt; Daniel H Mathalon; Thomas McGlashan; Diana O Perkins; Larry J Seidman; Ming T Tsuang; Elaine F Walker; Scott W Woods; Tyrone D Cannon Journal: Am J Psychiatry Date: 2019-09-06 Impact factor: 18.112
Authors: Louise B Glenthøj; Birgitte Fagerlund; Carsten Hjorthøj; Jens R M Jepsen; Nikolaj Bak; Tina D Kristensen; Christina Wenneberg; Kristine Krakauer; David L Roberts; Merete Nordentoft Journal: Schizophr Res Cogn Date: 2016-07-08