Prediction of Functional Outcome in Individuals at Clinical High Risk for Psychosis

作者：Ricardo E. Carrión, Danielle McLaughlin, Terry E. Goldberg, Andrea M. Auther, Ruth Olsen, Doreen M. Olvet, Christoph U. Correll, Barbara A. Cornblatt · 发表于：JAMA Psychiatry · 年份：2013 · DOI：10.1001/jamapsychiatry.2013.1909 · 被引用次数：253 · 研究领域：Schizophrenia research and treatment、Mental Health and Psychiatry、Healthcare Decision-Making and Restraints

IMPORTANCE: A major public health concern associated with schizophrenia and psychotic disorders is the long-term disability that involves impaired cognition, lack of social support, and an inability to function independently in the community. A critical goal of early detection and intervention studies in psychosis is therefore to understand the factors leading to this often profound impairment. OBJECTIVE: To develop a predictive model of functional (social and role) outcome in a clinical high-risk sample for psychosis. DESIGN: Prospective, naturalistic, longitudinal 3- to 5-year follow-up study. SETTING: The Recognition and Prevention Program in New York, a research clinic located in the Zucker Hillside Hospital in New York. PARTICIPANTS: One hundred one treatment-seeking patients at clinical high risk for psychosis. Ninety-two (91%) were followed up prospectively for a mean (SD) of 3 (1.6) years. INTERVENTION: Neurocognitive and clinical assessment. MAIN OUTCOMES AND MEASURES: The primary outcome variables were social and role functioning at the last follow-up visit. RESULTS: Poor social outcome was predicted by reduced processing speed (odds ratio [OR], 1.38; 95% CI, 1.050-1.823; P = .02), impaired social functioning at baseline (OR, 1.85; 95% CI, 1.258-2.732; P = .002), and total disorganized symptoms (OR, 5.06; 95% CI, 1.548-16.527; P = .007). Reduced performance on tests for verbal memory (OR, 1.74; 95% CI, 1.169-2.594; P = .006), role functioning at baseline (OR, 1.34; ...