Sylvia Romanowska1, Glenda MacQueen1, Benjamin I Goldstein2,3,4, JianLi Wang5,6, Sidney H Kennedy7,8,9,10,11, Signe Bray1,12,13,14, Catherine Lebel1,12,13,14, Jean Addington1. 1. Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada. 2. Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. 3. Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 4. Department of Pharmacology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 5. Work & Mental Health Research Unit, Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada. 6. School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. 7. Department of Psychiatry, University Health Network, Toronto, Ontario, Canada. 8. Department of Psychiatry, St. Michael's Hospital, Toronto, Ontario, Canada. 9. Arthur Sommer Rotenberg Chair in Suicide and Depression Studies, St. Michael's Hospital, Toronto, Ontario, Canada. 10. Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada. 11. Krembil Research Institute, University Health Network, Toronto, Ontario, Canada. 12. Department of Radiology, University of Calgary, Calgary, Alberta, Canada. 13. Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada. 14. Child & Adolescent Imaging Research (CAIR) Program, Calgary, Alberta, Canada.
Abstract
AIM: Functional impairment is common in serious mental illness (SMI). This study assessed social and role functioning in a sample of youth at risk of SMI who met different stages of risk based on a transdiagnostic clinical staging model described by McGorry and colleagues. METHOD: The sample consisted of 243 male and female youths aged 12-26 and included: non-help-seeking youth with risk factors (stage 0; n = 41); youth with mild symptoms (stage 1a; n = 52); youth with attenuated psychiatric syndromes (stage 1b; n = 108); and healthy controls (HCs; n = 42). Social and role functioning were assessed with the Global Functioning: Social and Role scales. RESULTS: Participants in stage 1b (attenuated syndromes) had significantly poorer social and role functioning than stage 0 participants and HCs (P < .001) and poorer social functioning than stage 1a (P < .05). Stage 1a participants had significantly poorer social functioning than HCs (P < .01) and significantly poorer role functioning than stage 0 participants (P < .01). Participants in stages 1a and 1b did not significantly differ from each other in role functioning only. CONCLUSIONS: This study demonstrates that mild to moderate functional impairments are present in young people experiencing subthreshold psychiatric symptoms and distress in the absence of a diagnosable mental illness. Results partially validate the model in that social although not role functioning declines across the stages.
AIM: Functional impairment is common in serious mental illness (SMI). This study assessed social and role functioning in a sample of youth at risk of SMI who met different stages of risk based on a transdiagnostic clinical staging model described by McGorry and colleagues. METHOD: The sample consisted of 243 male and female youths aged 12-26 and included: non-help-seeking youth with risk factors (stage 0; n = 41); youth with mild symptoms (stage 1a; n = 52); youth with attenuated psychiatric syndromes (stage 1b; n = 108); and healthy controls (HCs; n = 42). Social and role functioning were assessed with the Global Functioning: Social and Role scales. RESULTS:Participants in stage 1b (attenuated syndromes) had significantly poorer social and role functioning than stage 0 participants and HCs (P < .001) and poorer social functioning than stage 1a (P < .05). Stage 1a participants had significantly poorer social functioning than HCs (P < .01) and significantly poorer role functioning than stage 0 participants (P < .01). Participants in stages 1a and 1b did not significantly differ from each other in role functioning only. CONCLUSIONS: This study demonstrates that mild to moderate functional impairments are present in young people experiencing subthreshold psychiatric symptoms and distress in the absence of a diagnosable mental illness. Results partially validate the model in that social although not role functioning declines across the stages.
Authors: Joseph S DeLuca; Nicole D Andorko; Doha Chibani; Samantha Y Jay; Pamela J Rakhshan Rouhakhtar; Emily Petti; Mallory J Klaunig; Elizabeth C Thompson; Zachary B Millman; Kathleen M Connors; LeeAnn Akouri-Shan; John Fitzgerald; Samantha L Redman; Caroline Roemer; Miranda A Bridgwater; Jordan E DeVylder; Cheryl A King; Steven C Pitts; Shauna P Reinblatt; Heidi J Wehring; Kristin L Bussell; Natalee Solomon; Sarah M Edwards; Gloria M Reeves; Robert W Buchanan; Jason Schiffman Journal: J Psychother Integr Date: 2020-06