title: Functional development in clinical high risk youth: prediction of schizophrenia versus other psychotic disorders.
abstract: This study evaluates premorbid social and academic functioning in clinical high-risk individuals as predictors of transition to schizophrenia versus another psychotic disorder. Participants were 54 individuals enrolled in phase one of the North American Prodrome Longitudinal Study who over two and a half years of follow-up met criteria for schizophrenia/schizophreniform disorder (n=28) or another psychotic disorder (n=26). Social and academic functioning in childhood, early adolescence, and late adolescence was assessed at baseline using the Cannon-Spoor Premorbid Adjustment Scale. Social maladjustment in late adolescence predicted significantly higher odds of transition to schizophrenia versus another psychotic disorder independent of childhood and early adolescent adjustment (OR=4.02) and conveyed unique risk over academic maladjustment (OR=5.64). Premorbid academic maladjustment was not associated with psychotic disorder diagnosis. Results support diagnostic specificity of premorbid social dysfunction to schizophrenia in clinical high-risk youth and underscore an important role for social maladjustment in the developmental pathology of schizophrenia and its prediction.
authors.affiliation: Yale University School of Medicine, Department of Psychiatry, 34 Park Street, 38D, New Haven, CT 06519, USA. Electronic address: sarah.tarbox@yale.edu.
authors.forename: Sarah I
authors.initials: SI
authors.lastname: Tarbox
authors.affiliation: University of Calgary, Department of Psychiatry, Calgary, Alberta, Canada.
authors.forename: Jean
authors.initials: J
authors.lastname: Addington
authors.affiliation: University of California, San Diego, Department of Psychiatry, La Jolla, CA 92093, USA.
authors.forename: Kristin S
authors.initials: KS
authors.lastname: Cadenhead
authors.affiliation: University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095, USA.
authors.forename: Tyrone D
authors.initials: TD
authors.lastname: Cannon
authors.affiliation: The Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, NY 11004, USA; Albert Einstein College of Medicine, Department of Psychiatry, Bronx, NY 10461, USA; The Feinstein Institute for Medical Research, North Shore - Long Island Jewish Health System, Manhasset, NY 11030, USA.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Cornblatt
authors.affiliation: University of North Carolina at Chapel Hill, Department of Psychiatry, Chapel Hill, NC 27599, USA.
authors.forename: Diana O
authors.initials: DO
authors.lastname: Perkins
authors.affiliation: Harvard Medical School, Departments of Psychiatry at Massachusetts Mental Health Center Public Psychiatry Division, Beth Israel Deaconess Medical Center, and Massachusetts General Hospital, Boston, MA 02115, USA.
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Seidman
authors.affiliation: University of California, San Diego, Center for Behavioral Genomics, Department of Psychiatry, La Jolla, CA 92037, USA; Harvard Institute of Psychiatric Epidemiology and Genetics, Boston, MA 02115, USA.
authors.forename: Ming T
authors.initials: MT
authors.lastname: Tsuang
authors.affiliation: Emory University, Department of Psychology, Atlanta, GA 30322, USA.
authors.forename: Elaine F
authors.initials: EF
authors.lastname: Walker
authors.affiliation: National Institute of Mental Health, Division of Adult Translational Research and Treatment Development, Bethesda, MD 20892, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Heinssen
authors.affiliation: Yale University School of Medicine, Department of Psychiatry, 34 Park Street, 38D, New Haven, CT 06519, USA.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: McGlashan
authors.affiliation: Yale University School of Medicine, Department of Psychiatry, 34 Park Street, 38D, New Haven, CT 06519, USA.
authors.forename: Scott W
authors.initials: SW
authors.lastname: Woods
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D055815:Young Adult
keywords: Adolescence; Diagnosis; Premorbid; Prodrome; Prospective; Psychosis; Social adjustment