Functional development in clinical high risk youth: Prediction of schizophrenia versus other psychotic disorders

• Type of Material: Article
• Authors: Sarah I. Tarbox, Yale University; Jean Addington, University of Calgary; Kristin S. Cadenhead, University of California, San Diego; Tyrone D. Cannon, University of California, Los Angeles; Barbara A. Cornblatt, Zucker Hillside Hospital; Diana O. Perkins, University of North Carolina; Larry J. Seidman, Massachusetts General Hospital; Ming T. Tsuang, University of California, San Diego; Elaine Walker, Emory University; Robert Heinssen, National Institute of Mental Health; Thomas H. McGlashan, Yale University; Scott W. Woods, Yale University
• Language: English
• Date: 2014-01-30
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2013 Elsevier Ireland Ltd.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.psychres.2013.10.006
• Title of Journal or Parent Work: Psychiatry Research
• ISSN: 0165-1781
• Volume: 215
• Issue: 1
• Start Page: 52
• End Page: 60
• Grant/Funding Information: This work was supported by National Institute of Mental Health (U01 MH066134 to J.A.; R01 MH060720 and K24 MH76191 to K.S.C.; R01 MH065079 to T.D.C.; R01 MH061523 to B.A.C.; U01 MH066069 and P50 MH064065 to D.O.P; R01 MH065562 and P50 MH080272 to L.J.S.; R21 MH075027 to M.T.T; R01 MH062066 to E.F.W.; K05 MH01654 to T.H.M.; U01 MH066160 to S.W.W.); Donaghue Foundation (to S.W.W.); and Eli Lilly and Co (study HGGF to T.H.M., J.A., D.O.P.).
• Keywords: Social Adjustment; Follow-Up Studies; Male; Social adjustment; Young Adult; Premorbid; Longitudinal Studies; Psychotic Disorders; Adaptation, Psychological; Adolescence; Humans; Psychosis; Schizophrenic Psychology; Risk Factors; Diagnosis; Adolescent; Female; Prospective; Prodrome; Schizophrenia
• Research Categories: Health Sciences, Mental Health; Psychology, Clinical

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.