Social functioning in individuals at clinical high risk for psychosis

Abstract

Poor social functioning is a hallmark of schizophrenia. The purpose of this study was to examine social functioning in individuals at clinical high risk for psychosis. Social functioning was assessed in a sample of 86 clinical high risk (CHR) individuals and compared to that of 50 first-episode of psychosis (FE) subjects, 53 multi-episode schizophrenia subjects (ME) and 55 non-psychiatric controls (NPC). Subjects were assessed on the Social Functioning Scale (SFS), the Role Functioning subscale of the Quality of Life Scale (QLS-role), and the premorbid functioning scale. On the SFS, the CHR group did not differ significantly from the FE and ME groups and all were impaired relative to the NPCs. On QLS-role, the CHR group performed significantly better than the ME patients and significantly worse than NPCs. CHR subjects did not differ from patients in terms of premorbid functioning. This study demonstrates that even at the pre-psychotic phase of the illness, these young people are demonstrating significant deficits in social functioning, supporting that social deficits are present long before the onset of psychotic symptoms.

Comparing time use in individuals at different stages of psychosis and a non-clinical comparison group

“…These findings replicate previous research and support the hypothesis that social disability occurs prior to the onset of psychosis (Addington et al, 2008). Early social disability may play a key role in the development and onset of psychotic symptoms (French and Morrison, 2004).…”

“…difficulties engaging in meaningful activities and relationships) are a common and disabling feature of psychosis (Couture et al, 2006). A reduction in functioning has been identified prior to the onset of positive psychotic symptoms (Jang et al, 2011), with individuals at-risk of developing psychosis showing comparable impairments in social functioning to individuals following transition (Addington et al, 2008).…”

174.2 Psychosis Prediction: Stratification of Risk Estimation With Information-Processing and Premorbid Functioning Variables

“…Poor premorbid adjustment is characterized in a substantial proportion of schizophrenia patients by early and progressive deterioration in social functioning, which is present years before the onset of psychosis 53,55 and rarely improves over time. 56,57 In the seminal work of Strauss and Carpenter 58 on prediction of outcome in first-episode schizophrenia subjects, frequency of social contacts remained relatively stable over an 11-year follow-up period, indica ting that subjects with poor social functioning at baseline showed poor social functioning at 11-year follow-up.…”

Conceptualisation of recovery from psychosis: a service-user perspective

“…Some people have simply outlined recovery by singular factors such as symptoms, relapse rates and functioning. 3,4 Others have considered it to be a long-term process incorporating hope for the future, rebuilding self and rebuilding life. 5 Davidson et al outlined recovery as two superseding models: one that incorporates recovery as symptomatic and the other that adopts a sense of well-being regardless of symptoms.…”

“…In addition, symptom alleviation is important to recovery as psychotic symptoms have been shown to cause much distress, debilitation and reduction in social functioning. 4,13 Further support for symptom change as an important indicator of recovery is illustrated by the number of psychometrically reliable symptom outcome measures that have been developed. Outcome measures such as the Positive and Negative Syndrome Scale (PANSS), 14 the Brief Psychiatric Rating Scale (BPRS) 15 and the Psychotic Symptom Rating Scales (PSYRATS) 16 are commonly utilised illustrating the dominance of symptom alleviation as an indicator of recovery.…”