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EPA-0665 – Premorbid Adjustment Predicts Functional Outcome in Clinical High-Risk Patients. Results of the Epos Project.

Published online by Cambridge University Press:  15 April 2020

R.K.R. Salokangas
Affiliation:
Department of Psychiatry, University of Turku, Turku, Finland
M. Heinimaa
Affiliation:
Department of Psychiatry, University of Turku, Turku, Finland
T. From
Affiliation:
Department of Psychiatry, University of Turku, Turku, Finland
E. Löyttyniemi
Affiliation:
Department of Biostatistics, University of Turku, Turku, Finland
J. Hietala
Affiliation:
Department of Psychiatry, University of Turku, Turku, Finland
H. Graf von Reventlow
Affiliation:
Department of Psychiatry, Ruhr-University Bochum, Bochum, Germany
D. Linszen
Affiliation:
Department of Psychiatry and Psychology, University of Maastricht, Maastricht, Netherlands
M. Birchwood
Affiliation:
School of Psychology, University of Birmingham, Birmingham, United Kingdom
S. Ruhrmann
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
J. Klosterkötter
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany

Abstract

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Introduction:

In patients with schizophrenia, premorbid psychosocial adjustment is an important predictor of functional outcome. We studied functional outcome in young clinical high-risk (CHR) patients and how this was predicted by their premorbid adjustment.

Methods:

In all, 245 young help-seeking CHR patients were assessed with the Premorbid Adjustment Scale, the Structured Interview for Prodromal Syndromes (SIPS) and the Schizophrenia Proneness Instrument (SPI-A). The SIPS assesses positive, negative, disorganized, general symptoms, and the Global Assessment of Functioning (GAF), the SPI-A self-experienced basic symptoms; they were carried out at baseline, at 9- month and 18-month follow-up. Transitions to psychosis were identified. In the hierarchical linear model, associations between premorbid adjustment, background data, symptoms, transitions to psychosis and GAF scores were analyzed.

Results:

During the 18-month follow-up, GAF scores improved significantly, and the proportion of patients with poor functioning decreased from 45% to 25%. Low GAF scores were predicted by poor premorbid adjustment, negative, positive and basic symptoms, and poor baseline work status. The association between premorbid adjustment and follow-up GAF scores remained significant, even when baseline GAF and transition to psychosis were included in the model.

Conclusion:

A great majority of help-seeking CHR patients suffer from deficits in their functioning. In CHR patients, premorbid psychosocial adjustment, baseline positive, negative, basic symptoms and poor working/schooling situation predict poor short-term functional outcome. These aspects should be taken into account when acute intervention and long-term rehabilitation for improving outcome in CHR patients are executed.

Type
FC07 – Free Communications Session 07: Schizophrenia
Copyright
Copyright © European Psychiatric Association 2014
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