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

Sarah I Tarbox; Jean Addington; Kristin S Cadenhead; Tyrone D Cannon; Barbara A Cornblatt; Diana O Perkins; Larry J Seidman; Ming T Tsuang; Elaine F Walker; Robert Heinssen; Thomas H McGlashan; Scott W Woods

doi:10.1016/j.psychres.2013.10.006

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

Psychiatry Res. 2014 Jan 30;215(1):52-60. doi: 10.1016/j.psychres.2013.10.006. Epub 2013 Oct 18.

Authors

Affiliations

¹ Yale University School of Medicine, Department of Psychiatry, 34 Park Street, 38D, New Haven, CT 06519, USA. Electronic address: sarah.tarbox@yale.edu.
² University of Calgary, Department of Psychiatry, Calgary, Alberta, Canada.
³ University of California, San Diego, Department of Psychiatry, La Jolla, CA 92093, USA.
⁴ University of California, Los Angeles, Department of Psychology, Los Angeles, CA 90095, USA.
⁵ The Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewish Health System, Glen Oaks, NY 11004, USA; Albert Einstein College of Medicine, Department of Psychiatry, Bronx, NY 10461, USA; The Feinstein Institute for Medical Research, North Shore - Long Island Jewish Health System, Manhasset, NY 11030, USA.
⁶ University of North Carolina at Chapel Hill, Department of Psychiatry, Chapel Hill, NC 27599, USA.
⁷ Harvard Medical School, Departments of Psychiatry at Massachusetts Mental Health Center Public Psychiatry Division, Beth Israel Deaconess Medical Center, and Massachusetts General Hospital, Boston, MA 02115, USA.
⁸ University of California, San Diego, Center for Behavioral Genomics, Department of Psychiatry, La Jolla, CA 92037, USA; Harvard Institute of Psychiatric Epidemiology and Genetics, Boston, MA 02115, USA.
⁹ Emory University, Department of Psychology, Atlanta, GA 30322, USA.
¹⁰ National Institute of Mental Health, Division of Adult Translational Research and Treatment Development, Bethesda, MD 20892, USA.
¹¹ Yale University School of Medicine, Department of Psychiatry, 34 Park Street, 38D, New Haven, CT 06519, USA.

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.

Keywords: Adolescence; Diagnosis; Premorbid; Prodrome; Prospective; Psychosis; Social adjustment.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Adaptation, Psychological*
Adolescent
Female
Follow-Up Studies
Humans
Longitudinal Studies
Male
Psychotic Disorders / diagnosis*
Psychotic Disorders / psychology
Risk Factors
Schizophrenia / diagnosis*
Schizophrenic Psychology
Social Adjustment*
Young Adult

Abstract

Publication types

MeSH terms

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