Perceived stress mediates the relationship between social adaptation and quality of life in individuals at ultra high risk of psychosis

Abstract

Aim Quality of life (QoL) and social functioning have emerged as good predictors of the outcome of psychotic disorders. Poor QoL and social functioning are usually present before the onset of the first episode of psychosis. Our study aimed to explore the relationship between social adaptation and QoL in young people at risk of psychosis (ultra‐high‐risk, UHR) and healthy controls (HCs), and to investigate potential mediating effects of stress measures (perceived stress, stressful life events). Methods The study included 55 UHR subjects and 40 HC. Social functioning was assessed with the Social Adaptation Self‐evaluation Scale (SASS). Stress measures included the assessment of stressful life events and perceived stress. We compared stress and QoL measures between UHR and HC, and also compared UHR with low or normal social adaptation. A mediation analysis was performed to explore whether stress measures mediated the relationship between social adaptation and QoL. Results UHR were less frequently employed and reported more stress, poorer QoL and lower social adaptation than HC. QoL and social adaptation were associated with stress measures. UHR with low social adaptation reported more perceived stress and less QoL than UHR with normal social adaptation and HC. Perceived stress mediated the relationship between social adaptation and QoL. Conclusions Social adaptation is less developed in UHR subjects than in healthy subjects and has a negative impact on quality of life. This association is mediated by perceived stress.

Perceived stress, social functioning and quality of life in first‐episode psychosis: A 1‐year follow‐up study

“…Similar to the results in a previous study by Ortega et al (2019), we also found that perceived stress is a mediating variable of the relationship between social functioning and QoL. We found a mediating effect on the baseline visit but no effect 1 year later.…”

“…Other studies on FEP cohorts have reported that more daily activities and being employed are likely to be associated with a better QoL (Addington et al, 2003; Gardsjord et al, 2016; Tan et al, 2019). In line with these findings, a previous study by our group (Ortega et al, 2019) focused on ultra‐high‐risk (UHR) individuals found that UHR people with low social functioning reported more unemployment, increased perceived stress and less QoL than UHR people with normal social functioning and with healthy controls (HCs). Moreover, perceived stress mediated the relationship between social functioning and QoL.…”

“…The changes in QoL in early stages of psychosis spectrum disease have been shown to have an important impact on long‐term QoL (Karow et al, 2014). In a previous study by our group (Ortega et al, 2019) we concluded that social functioning was affected before the onset of psychosis in the prodromal phase. Thus, as expected in our sample, employment rates were lower in FEP individuals than in HCs, which are in line with previous studies on early psychosis disorder (Cotton et al, 2017; Rinaldi et al, 2010).…”

Social Adaptation in Context: The Differential Role of Religiosity and Self-Esteem in Vulnerable vs. Non-vulnerable Populations – A Registered Report Study

“…Despite these results, it is possible, however, that religiosity bolsters coping mechanisms that the concept and measure of social adaptation considered in this study fail to grasp. To further consider this idea, we conducted a regression analysis between religiosity and another variable, that according to the literature is related to social adaptation ( Shahrier et al, 2016 ; Ortega et al, 2019 ) and that was measured in both the control and the experiment group: perceived stress.…”

Association among resilience, post-traumatic stress disorder, and somatization in frontline healthcare workers in COVID-19: The mediating role of perceived stress

“…A similar phenomenon was observed in a previous study, which reported that perceived stress mediates the relationship between resilience and somatization in teachers, students, and healthcare workers (21). In addition, perceived stress can mediate the association between social adaption and quality of life in individuals at ultra-high risk for psychosis (41). Social adaption reflects resilience, whereas the quality of life reflects mental wellbeing.…”