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Distinct patterns of premorbid social functioning in first-episode psychosis: Relationship to initial presentation

Published online by Cambridge University Press:  16 April 2020

M.A. Parrilla-Escobar
Affiliation:
Department of Child Psychiatry, New York State Psychiatric Institute, New York, NY, USA
R. Perez-Iglesias
Affiliation:
Department of Psychiatry, University of Cantabria, University Hospital Marques de Valdecilla, School of Medicine, Santander, Spain
J.M. Pelayo-Teran
Affiliation:
Department of Psychiatry, University of Cantabria, University Hospital Marques de Valdecilla, School of Medicine, Santander, Spain
G. Pardo-Garcia
Affiliation:
Department of Psychiatry, University of Cantabria, University Hospital Marques de Valdecilla, School of Medicine, Santander, Spain
M.L. Ramirez-Bonilla
Affiliation:
Department of Psychiatry, University of Cantabria, University Hospital Marques de Valdecilla, School of Medicine, Santander, Spain
J.L. Vazquez-Barquero
Affiliation:
Department of Psychiatry, University of Cantabria, University Hospital Marques de Valdecilla, School of Medicine, Santander, Spain
B. Crespo-Facorro
Affiliation:
Department of Psychiatry, University of Cantabria, University Hospital Marques de Valdecilla, School of Medicine, Santander, Spain

Abstract

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Objective:

To explore different longitudinal patterns of social functioning before onset of psychotic illness and how they relate to clinical presentation, substance use and acute treatment response.

Methods:

Inclusion criteria: Drug-naïve first-episode psychosis, 18-50 yo, criteria for Schizophrenia or Other Psychotic Disorders (DSM-IV), excluding Psychotic Disorder due to a General Medical Condition and Substance-Induced Psychotic Disorder.

Exclusion criteria:

Mental Retardation, neurological disease, brain injury or drug dependence.

Measures:

Premorbid Adjustment Scale (PAS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS).

Statistical analysis:

Ward cluster analyses were carried out to differentiate three longitudinal patterns of social premorbid adjustment from childhood to late adolescence: stable good (N=75), stable bad (N=44) and deteriorating (N=35). Chi-square and ANOVA tests were used.

Results:

154 subjects (64.5% male, mean age 26.81, SD=6.98) participated in the study.

At baseline the socially stable good group had more positive symptoms, SAPS 13.85 (3.99), than the stable bad group, SAPS 11.82 (3.93) (p=0.023).

At six weeks post-treatment the socially deteriorating group had more negative symptoms, SANS 8 (4.89), than the stable good, SANS 3.85 (4.11), and the stable bad, SANS 5.23 (5.45) (p=0.000).

The stable good group had the highest rates of substance use, followed by the deteriorating group.

Conclusions:

A good premorbid social life was related to higher substance use and more positive symptoms at presentation. A social deteriorating pattern was associated with more negative symptoms at baseline and six weeks post-treatment. These differences would argue for different pathogeneses of psychosis.

Type
Poster Session 2: Anxiety, Stress Related, Impulse and Somatoform Disorders
Copyright
Copyright © European Psychiatric Association 2007
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