With the aid of a NARSAD Grant, a new study of adolescents at high risk for developing psychosis found that their long-term functioning is not solely dependent on the progression or development of full-blown psychosis. The findings, published online September 4th in JAMA Psychiatry, show that regardless of psychosis “conversion” (early warning symptoms developing into full-blown psychosis), the at-risk adolescents were at higher risk for poor functional outcomes, including impaired cognition, lack of social support and an inability to function independently in the community.
Led by NARSAD Young Investigator Grantee, Ricardo Carrión, Ph.D., of the Zucker Hillside Hospital in Glen Oaks, New York, researchers examined 92 teens who showed early warning signs of psychosis (such as delusional ideas or social difficulties) that are troubling, but aren’t strong enough to meet the criteria for a diagnosis of a psychotic disorder (such as schizophrenia or bipolar disorder). The adolescents (average age 16 years) were followed up for an average of three years. Fifteen developed psychosis, and had generally poor outcomes, with 86.7 percent and 66.7 percent having poor social and role outcomes, respectively. However, among the 77 who did not develop psychosis, there were also poor social and role outcomes with corresponding rates of 40.3 percent and 45.5 percent, respectively.
The researchers found that neurocognitive performance and functioning level at baseline (relative to 68 mentally healthy controls) were also predictors of functional outcomes, independent of the development of psychosis. “Our results demonstrate that a preventive approach to psychosis should be extended to include relevant functional outcomes, because these markers provided relevant discrimination between individuals with poor and good outcomes,” Dr. Carrión et. al. write in JAMA Psychiatry.
“These adolescents and young adults are both at risk for psychosis and functional disability,” say the researchers. “Thus, prevention is needed for emerging psychosis, as well as for helping these individuals cope with persistent relationship and school/work difficulties.”
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