title: Functional outcome in major psychiatric disorders and associated clinical and psychosocial variables: A potential cross-diagnostic phenotype for further genetic investigations?
abstract: OBJECTIVE
  Functional outcome has recently become of interest for cross-diagnostic subphenotype approaches in psychiatric genetics. Therefore, it is crucial to know about clinical, demographic and psychosocial variables that correlate with long-term functioning. Unfortunately, there is a lack of studies that directly compare the importance of correlates for functional outcome between different disorders.
  
  
  METHODS
  Applying regression models to samples of patients with schizophrenia (SZ, n = 238), bipolar disorder (BD, n = 533) and major depressive disorder (MDD, n = 398), we compared the magnitude of association of potential correlates with functional outcome, measured by the Global Assessment of Functioning (GAF) score.
  
  
  RESULTS
  Shared correlates for worse functional outcome were poor premorbid functioning, insidious illness onset and poor premorbid work or social adjustment in all three disorders, and negative symptomatology in SZ and BD. Disorder-specific correlates for SZ were longer duration of illness, lower functioning during episodes and being life-time single, for BD substance abuse and suicidality, and for MDD premorbid unemployment and having a premorbid personality disorder.
  
  
  CONCLUSIONS
  We found different patterns of correlates for long-term functioning in SZ, BD and MDD. Knowledge of these patterns may improve the quality of genetic investigations focussing on functional outcome.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University , Göttingen , Germany.
authors.forename: Katrin
authors.initials: K
authors.lastname: Gade
authors.forename: Dörthe
authors.initials: D
authors.lastname: Malzahn
authors.forename: Heike
authors.initials: H
authors.lastname: Anderson-Schmidt
authors.forename: Jana
authors.initials: J
authors.lastname: Strohmaier
authors.forename: Sandra
authors.initials: S
authors.lastname: Meier
authors.forename: Josef
authors.initials: J
authors.lastname: Frank
authors.forename: Peter G
authors.initials: PG
authors.lastname: Falkai
authors.forename: Marcella
authors.initials: M
authors.lastname: Rietschel
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Schulze
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000235:genetics / Q000503:physiopathology*; D003865:Major Depressive Disorder / Q000235:genetics / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D010554:Personality Disorders; D010641:Phenotype; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000235:genetics / Q000503:physiopathology*; D013405:Suicide; D014478:Unemployment; D055815:Young Adult
keywords: bipolar disorder; global functioning; major depression; schizophrenia; subphenotype