Eva Velthorst1, Anne-Kathrin J Fett1, Avraham Reichenberg1, Greg Perlman1, Jim van Os1, Evelyn J Bromet1, Roman Kotov1. 1. From the Department of Psychiatry and the Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York; the Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; the Department of Educational Neuroscience and Research Institute LEARN! Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, the Netherlands; the Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, U.K.; the Department of Psychiatry, Stony Brook University, Stony Brook, N.Y.; and the Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, the Netherlands.
Abstract
OBJECTIVE: Social impairment is a long-recognized core feature of schizophrenia and is common in other psychotic disorders. Still, to date the long-term trajectories of social impairment in psychotic disorders have rarely been studied systematically. METHODS: Data came from the Suffolk County Mental Health Project, a 20-year prospective study of first-admission patients with psychotic disorders. A never-psychotic comparison group was also assessed. Latent class growth analysis was applied to longitudinal data on social functioning from 485 respondents with schizophrenia spectrum disorders and psychotic mood disorders, and associations of the empirically derived trajectories with premorbid social adjustment, diagnosis, and 20-year outcomes were examined. RESULTS: Four mostly stable trajectories of preserved (N=82; 59th percentile of comparison group sample distribution), moderately impaired (N=148; 17th percentile), severely impaired (N=181; 3rd percentile), and profoundly impaired (N=74; 1st percentile) functioning best described the 20-year course of social functioning across diagnoses. The outcome in the group with preserved functioning did not differ from that of never-psychotic individuals at 20 years, but the other groups functioned significantly worse. Differences among trajectories were already evident in childhood. The two most impaired trajectories started to diverge in early adolescence. Poorer social functioning trajectories were strongly associated with other real-world outcomes at 20 years. Multiple trajectories were represented within each disorder. However, more participants with schizophrenia spectrum disorders had impaired trajectories, and more with mood disorders had better functioning trajectories. CONCLUSIONS: The results highlight substantial variability of social outcomes within diagnoses-albeit overall worse social outcomes in schizophrenia spectrum disorders-and show remarkably stable long-term impairments in social functioning after illness onset across all diagnoses.
OBJECTIVE:Social impairment is a long-recognized core feature of schizophrenia and is common in other psychotic disorders. Still, to date the long-term trajectories of social impairment in psychotic disorders have rarely been studied systematically. METHODS: Data came from the Suffolk County Mental Health Project, a 20-year prospective study of first-admission patients with psychotic disorders. A never-psychotic comparison group was also assessed. Latent class growth analysis was applied to longitudinal data on social functioning from 485 respondents with schizophrenia spectrum disorders and psychotic mood disorders, and associations of the empirically derived trajectories with premorbid social adjustment, diagnosis, and 20-year outcomes were examined. RESULTS: Four mostly stable trajectories of preserved (N=82; 59th percentile of comparison group sample distribution), moderately impaired (N=148; 17th percentile), severely impaired (N=181; 3rd percentile), and profoundly impaired (N=74; 1st percentile) functioning best described the 20-year course of social functioning across diagnoses. The outcome in the group with preserved functioning did not differ from that of never-psychotic individuals at 20 years, but the other groups functioned significantly worse. Differences among trajectories were already evident in childhood. The two most impaired trajectories started to diverge in early adolescence. Poorer social functioning trajectories were strongly associated with other real-world outcomes at 20 years. Multiple trajectories were represented within each disorder. However, more participants with schizophrenia spectrum disorders had impaired trajectories, and more with mood disorders had better functioning trajectories. CONCLUSIONS: The results highlight substantial variability of social outcomes within diagnoses-albeit overall worse social outcomes in schizophrenia spectrum disorders-and show remarkably stable long-term impairments in social functioning after illness onset across all diagnoses.
Authors: Anne-Kathrin J Fett; Wolfgang Viechtbauer; Maria-de-Gracia Dominguez; David L Penn; Jim van Os; Lydia Krabbendam Journal: Neurosci Biobehav Rev Date: 2010-07-08 Impact factor: 8.989
Authors: Robert Paul Liberman; Daniel Gutkind; Jim Mintz; Michael Green; B D Marshall; Mary Jane Robertson; Jeffery Hayden Journal: Compr Psychiatry Date: 2002 Nov-Dec Impact factor: 3.735
Authors: M Tohen; S M Strakowski; C Zarate; J Hennen; A L Stoll; T Suppes; G L Faedda; B M Cohen; P Gebre-Medhin; R J Baldessarini Journal: Biol Psychiatry Date: 2000-09-15 Impact factor: 13.382
Authors: Sean A P Clouston; Katherine Jonas; Laura J Fochtmann; Evelyn J Bromet; Roman Kotov Journal: J Gerontol A Biol Sci Med Sci Date: 2020-06-18 Impact factor: 6.053
Authors: Dora M Raymaker; Tamara Sale; Mariam Rija; Nicholas Buekea; Nybelle Caruso; Ryan Melton; Natalie Cohrs; Veronica Gould; Christina Wall; Mirah Scharer Journal: Prog Community Health Partnersh Date: 2020
Authors: Camilla Jerlang Christiani; Jens R M Jepsen; Anne Thorup; Nicoline Hemager; Ditte Ellersgaard; Katrine S Spang; Birgitte K Burton; Maja Gregersen; Anne Søndergaard; Aja N Greve; Ditte L Gantriis; Gry Poulsen; Md Jamal Uddin; Larry J Seidman; Ole Mors; Kerstin J Plessen; Merete Nordentoft Journal: Schizophr Bull Date: 2019-10-24 Impact factor: 9.306
Authors: Gaurav H Patel; Sophie C Arkin; Daniel R Ruiz-Betancourt; Heloise M DeBaun; Nicole E Strauss; Laura P Bartel; Jack Grinband; Antigona Martinez; Rebecca A Berman; David A Leopold; Daniel C Javitt Journal: Psychol Med Date: 2020-06-05 Impact factor: 7.723
Authors: Jacob Cookey; Jacob McGavin; Candice E Crocker; Kara Matheson; Sherry H Stewart; Philip G Tibbo Journal: Can J Psychiatry Date: 2020-02-04 Impact factor: 4.356