title: Longitudinal patterns of social functioning and conversion to psychosis in subjects at ultra-high risk.
abstract: OBJECTIVE
  Impaired social functioning is one of the defining features of patients with schizophrenia and subjects at ultra-high risk (UHR) for psychosis. This prospective study aimed to investigate the course of social dysfunction in UHR subjects and to examine its relationship with later conversion to psychosis. The effect of pharmacotherapy on the course of social dysfunction was also examined.
  
  
  METHODS
  A total of 57 UHR subjects and 58 healthy controls participated in this study. The Social Functioning Scale (SFS) was used to assess social functioning of UHR subjects at baseline and at the 1 year follow up. The changes in social functioning of UHR subjects have been examined to compare the social functioning of those who later converted to psychosis ('converters') with those who did not ('non-converters'). The effect of pharmacotherapy on longitudinal change in social functioning was also evaluated.
  
  
  RESULTS
  Subjects at UHR for psychosis showed more impaired social functioning at baseline than did healthy controls. Moreover, the course of social dysfunction of the converter and non-converter groups differed during the 1 year follow up period. The converters showed decreases in SFS average (F (1,32) = 7.85, p = 0.009) and interpersonal behaviour (F (1,32) = 10.43, p = 0.003) scores over time, whereas the non-converters showed increased scores. Additionally, we found that pharmacological treatment was associated with increased prosocial activities score (F (1,32) = 4.66, p = 0.038).
  
  
  CONCLUSIONS
  We found that the social functioning of converters was impaired before the onset of the psychosis and further declined during the at-risk phase. A series of social functioning indices in the longitudinal course may be helpful in predicting conversion to psychosis in subjects at UHR. Appropriate pharmacotherapy can offer clinical benefits by improving social functioning in UHR individuals.
authors.affiliation: Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Joon Hwan
authors.initials: JH
authors.lastname: Jang
authors.forename: Na Young
authors.initials: NY
authors.lastname: Shin
authors.forename: Geumsook
authors.initials: G
authors.lastname: Shim
authors.forename: Hye Yoon
authors.initials: HY
authors.lastname: Park
authors.forename: Euitae
authors.initials: E
authors.lastname: Kim
authors.forename: Go-Eun
authors.initials: GE
authors.lastname: Jang
authors.forename: Soo Jin
authors.initials: SJ
authors.lastname: Kwon
authors.forename: Ji-Won
authors.initials: JW
authors.lastname: Hur
authors.forename: Suk Kyoon
authors.initials: SK
authors.lastname: An
authors.forename: Jun Soo
authors.initials: JS
authors.lastname: Kwon
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008137:Longitudinal Studies; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000188:drug therapy / Q000523:psychology*; D012306:Risk; D012559:Schizophrenia / Q000188:drug therapy; D012565:Schizophrenic Psychology; D012680:Sensitivity and Specificity; D012917:Social Adjustment; D012919:Social Behavior
chemical_list: D014150:Antipsychotic Agents