Disability in people clinically at high risk of psychosis.
BACKGROUND
Decline in social functioning occurs in individuals who later develop psychosis.


OBJECTIVE
To investigate whether baseline differences in disability are present in those who do and those who do not make a transition to psychosis in a group clinically at high risk and whether disability is a risk factor for transition.


METHODS
Prospective multicentre, naturalistic field study with an 18-month follow-up period on 245 help-seeking individuals clinically at high risk. Disability was assessed with the Disability Assessment Schedule of the World Health Organization (WHODAS-II).


RESULTS
At baseline, the transition group displayed significantly greater difficulties in making new friends (z = -3.40, P = 0.001), maintaining a friendship (z =-3.00, P = 0.003), dealing with people they do not know (z =-2.28, P = 0.023) and joining community activities (z =-2.0, P = 0.05) compared with the non-transition group. In Cox regression, difficulties in getting along with people significantly contributed to the prediction of transition to psychosis in our sample (β = 0.569, s.e. = 0.184, Wald = 9.548, P = 0.002, hazard ratio (HR) = 1.767, 95% CI 1.238-2.550).


CONCLUSIONS
Certain domains of social disability might contribute to the prediction of psychosis in a sample clinically at high risk.
Velthorst
Eva
E
Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Nieman
Dorien H
DH
Linszen
Don
D
Becker
Hiske
H
de Haan
Lieuwe
L
Dingemans
Peter M
PM
Birchwood
Max
M
Patterson
Paul
P
Salokangas
Raimo K R
RK
Heinimaa
Markus
M
Heinz
Andreas
A
Juckel
Georg
G
von Reventlow
Heinrich Graf
HG
French
Paul
P
Stevens
Helen
H
Schultze-Lutter
Frauke
F
Klosterkötter
Joachim
J
Ruhrmann
Stephan
S
D000203:Activities of Daily Living / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D002648:Child; D006233:Persons with Disabilities / Q000523:psychology*; D018450:Disease Progression; D042241:Early Diagnosis; D005060:Europe; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D053208:Kaplan-Meier Estimate; D008297:Male; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology; D012565:Schizophrenic Psychology; D058992:Social Participation / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult