Psychosocial outcome in patients at clinical high risk of psychosis: a prospective follow-up

Salokangas, Raimo K. R.; Nieman, Dorien H.; Heinimaa, Markus; Svirskis, Tanja; Luutonen, Sinikka; From, Tiina; von Reventlow, Heinrich Graf; Juckel, Georg; Linszen, Don; Dingemans, Peter; Birchwood, Max; Patterson, Paul; Schultze-Lutter, Frauke; Klosterkötter, Joachim; Ruhrmann, Stephan (2013). Psychosocial outcome in patients at clinical high risk of psychosis: a prospective follow-up. Social psychiatry and psychiatric epidemiology, 48(2), pp. 303-311. Berlin: Springer 10.1007/s00127-012-0545-2

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Purpose In patients at clinical high risk (CHR) of psychosis, transition to psychosis has been the focus of recent studies. Their broader outcome has received less attention. We studied psychosocial state and outcome in CHR patients. Methods In the European Prediction of Psychosis Study, 244 young help-seeking CHR patients were assessed with the Strauss and Carpenter Prognostic Scale (SCPS) at baseline, and 149 (61.1 %) of them were assessed for the second time at the 18-month follow-up. The followed patients were classified into poor and good outcome groups. Results Female gender, ever-married/cohabitating relationship, and good working/studying situation were associated with good baseline SCPS scores. During follow-up, patients’ SCPS scores improved significantly. Good follow-up SCPS scores were predicted by higher level of education, good working/studying status at baseline, and white ethnicity. One-third of the followed CHR patients had poor global outcome. Poor working/studying situation and lower level of education were associated with poor global outcome. Transition to psychosis was associated with baseline, but not with follow-up SCPS scores or with global outcome. Conclusion The majority of CHR patients experience good short-term recovery, but one-third have poor psychosocial outcome. Good working situation is the major indicator of good outcome, while low level of education and non-white ethnicity seem to be associated with poor outcome. Transition to psychosis has little effect on psychosocial outcome in CHR patients. In treating CHR patients, clinicians should focus their attention on a broader outcome, and not only on preventing transition to psychosis.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > University Psychiatric Services > University Hospital of Child and Adolescent Psychiatry and Psychotherapy
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Child and Adolescent Psychiatry and Psychotherapy > Research Division

UniBE Contributor:

Schultze-Lutter, Frauke

Subjects:

100 Philosophy > 150 Psychology
600 Technology > 610 Medicine & health

ISSN:

0933-7954

Publisher:

Springer

Language:

English

Submitter:

Myriam Pyrlik

Date Deposited:

04 Oct 2013 14:36

Last Modified:

11 Apr 2014 09:14

Publisher DOI:

10.1007/s00127-012-0545-2

PubMed ID:

22797132

Web of Science ID:

000313814500014

URI:

https://boris.unibe.ch/id/eprint/14653 (FactScience: 221733)

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