Els van der Ven1, Jennifer Scodes2, Cale Basaraba2, Luca Pauselli3, Franco Mascayano4, Ilana Nossel3, Iruma Bello3, Jennifer Humensky5, Ezra Susser4, Melanie Wall4, Lisa Dixon6. 1. Mailman School of Public Health, Columbia University, New York, NY, USA; School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands. Electronic address: e.vanderven@maastrichtuniversity.nl. 2. Mental Health Data Science, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA. 3. New York State Psychiatric Institute, New York, NY, USA; Division of Behavioral Health Services and Policy Research, Columbia University, New York, NY, USA. 4. Mailman School of Public Health, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA. 5. New York State Psychiatric Institute, New York, NY, USA. 6. New York State Psychiatric Institute, New York, NY, USA; Division of Behavioral Health Services and Policy Research & Center for Practice Innovations, Columbia University, New York, NY, USA.
Abstract
BACKGROUND: Despite the benefits of early intervention services for the initial stages of psychosis ongoing impairments in functioning are common. AIMS: To identify 1-year trajectories of occupational and social functioning in individuals enrolled in OnTrackNY, a statewide program offering early intervention services for recent-onset psychosis in community settings. METHOD: We included 937 persons with recent-onset psychosis enrolled at 19 programs across New York State. Demographic, social and clinical data was collected at program entry and at 3, 6, 9 and 12 months. We used growth mixture models to identify occupational and social functioning trajectories and examined the association between trajectory class, baseline factors and symptoms during 1-year follow-up. RESULTS: Four distinct trajectory classes of occupational and social functioning were identified. The converging (58.0%) class had disparate levels of functioning at baseline (low occupational, higher social) which eventually converged. The other classes had high-stable (14.8%), moderate-stable (17.8%) and low-improving (9.4%) trajectories. Female gender, educational attainment and private insurance status were significantly associated with the trajectory characterized by higher functioning, while living alone, homelessness, a longer period from psychosis onset to program enrollment, a schizophrenia diagnosis and cannabis use at enrollment were associated with the poorest trajectory. The differences in severity of symptoms by trajectory class diminished over time. CONCLUSIONS: Trajectories of occupational and social functioning showed substantial variation, but overall, remained stable or improved during 1-year follow-up. The relationship between symptoms and occupational and social functioning attenuated after the acute treatment phase.
BACKGROUND: Despite the benefits of early intervention services for the initial stages of psychosis ongoing impairments in functioning are common. AIMS: To identify 1-year trajectories of occupational and social functioning in individuals enrolled in OnTrackNY, a statewide program offering early intervention services for recent-onset psychosis in community settings. METHOD: We included 937 persons with recent-onset psychosis enrolled at 19 programs across New York State. Demographic, social and clinical data was collected at program entry and at 3, 6, 9 and 12 months. We used growth mixture models to identify occupational and social functioning trajectories and examined the association between trajectory class, baseline factors and symptoms during 1-year follow-up. RESULTS: Four distinct trajectory classes of occupational and social functioning were identified. The converging (58.0%) class had disparate levels of functioning at baseline (low occupational, higher social) which eventually converged. The other classes had high-stable (14.8%), moderate-stable (17.8%) and low-improving (9.4%) trajectories. Female gender, educational attainment and private insurance status were significantly associated with the trajectory characterized by higher functioning, while living alone, homelessness, a longer period from psychosis onset to program enrollment, a schizophrenia diagnosis and cannabis use at enrollment were associated with the poorest trajectory. The differences in severity of symptoms by trajectory class diminished over time. CONCLUSIONS: Trajectories of occupational and social functioning showed substantial variation, but overall, remained stable or improved during 1-year follow-up. The relationship between symptoms and occupational and social functioning attenuated after the acute treatment phase.
Authors: Kelly K Anderson; Ross Norman; Arlene G MacDougall; Jordan Edwards; Lena Palaniyappan; Cindy Lau; Paul Kurdyak Journal: Psychol Med Date: 2018-10-12 Impact factor: 7.723
Authors: Michael Schoenbaum; Jason M Sutherland; Andre Chappel; Susan Azrin; Amy B Goldstein; Agnes Rupp; Robert K Heinssen Journal: Schizophr Bull Date: 2017-10-21 Impact factor: 9.306
Authors: Christoph U Correll; Britta Galling; Aditya Pawar; Anastasia Krivko; Chiara Bonetto; Mirella Ruggeri; Thomas J Craig; Merete Nordentoft; Vinod H Srihari; Sinan Guloksuz; Christy L M Hui; Eric Y H Chen; Marcelo Valencia; Francisco Juarez; Delbert G Robinson; Nina R Schooler; Mary F Brunette; Kim T Mueser; Robert A Rosenheck; Patricia Marcy; Jean Addington; Sue E Estroff; James Robinson; David Penn; Joanne B Severe; John M Kane Journal: JAMA Psychiatry Date: 2018-06-01 Impact factor: 21.596
Authors: Jo Hodgekins; Max Birchwood; Rose Christopher; Max Marshall; Sian Coker; Linda Everard; Helen Lester; Peter Jones; Tim Amos; Swaran Singh; Vimal Sharma; Nick Freemantle; David Fowler Journal: Br J Psychiatry Date: 2015-08-20 Impact factor: 9.319