PMID- 33131983
OWN - NLM
STAT- MEDLINE
DCOM- 20210617
LR  - 20210617
IS  - 1573-2509 (Electronic)
IS  - 0920-9964 (Linking)
VI  - 227
DP  - 2021 Jan
TI  - Social decline in the psychosis prodrome: Predictor potential and heterogeneity 
      of outcome.
PG  - 44-51
LID - S0920-9964(20)30464-3 [pii]
LID - 10.1016/j.schres.2020.09.006 [doi]
AB  - BACKGROUND: While an established clinical outcome of high importance, social 
      functioning has been emerging as possibly having a broader significance to the 
      evolution of psychosis and long term disability. In the current study we explored 
      the association between social decline, conversion to psychosis, and functional 
      outcome in individuals at clinical high risk (CHR) for psychosis. METHODS: 585 
      subjects collected in the North American Prodrome Longitudinal Study (NAPLS2) 
      were divided into 236 Healthy Controls (HCs), and CHR subjects that developed 
      psychosis (CHR + C, N = 79), or those that did not (Non-Converters, CHR-NC, 
      N = 270). CHR + C subjects were further divided into those that experienced an 
      atypical decline in social functioning prior to baseline (beyond typical 
      impairment levels) when in min-to-late adolescence (CHR + C-SD, N = 39) or those 
      that did not undergoing a decline (CHR + C-NSD, N = 40). RESULTS: Patterns of 
      poor functional outcomes varied across the CHR subgroups: CHR-NC (Poor Social 
      36.3%, Role 42.2%) through CHR + C-NSD (Poor Social 50%, Poor Role 67.5%) to 
      CHR + C-SD (Poor Social 76.9%, Poor Role 89.7%) functioning. The two Converter 
      subgroups had comparable positive symptoms at baseline. At 12 months, the 
      CHR + C-SD group stabilized, but social functioning levels remained significantly 
      lower than the other two subgroups. CONCLUSIONS: The current study demonstrates 
      that pre-baseline social decline in mid-to-late adolescence predicts psychosis. 
      In addition, we found that this social decline in converters is strongly 
      associated with especially poor functional outcome and overall poorer prognosis. 
      Role functioning, in contrast, has not shown similar predictor potential, and 
      rather appears to be an illness indicator that worsens over time.
CI  - Copyright (c) 2020 Elsevier B.V. All rights reserved.
FAU - Carrion, Ricardo E
AU  - Carrion RE
AD  - Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, 
      Glen Oaks, NY, United States; Institute of Behavioral Science, Feinstein 
      Institute for Medical Research, Northwell Health, Manhasset, NY, United States; 
      Department of Psychiatry, Donald and Barbara Zucker School of Medicine at 
      Hofstra/Northwell, Hempstead, New York 11549, United States.
FAU - Auther, Andrea M
AU  - Auther AM
AD  - Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, 
      Glen Oaks, NY, United States; Department of Psychiatry, Donald and Barbara Zucker 
      School of Medicine at Hofstra/Northwell, Hempstead, New York 11549, United 
      States.
FAU - McLaughlin, Danielle
AU  - McLaughlin D
AD  - Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, 
      Glen Oaks, NY, United States.
FAU - Addington, Jean
AU  - Addington J
AD  - Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, 
      Calgary, Alberta, Canada.
FAU - Bearden, Carrie E
AU  - Bearden CE
AD  - Semel Institute for Neuroscience and Human Behavior and Department of Psychology, 
      University of California, Los Angeles, Los Angeles, CA, United States.
FAU - Cadenhead, Kristin S
AU  - Cadenhead KS
AD  - Department of Psychiatry, University of California, San Diego, La Jolla, CA, 
      United States.
FAU - Cannon, Tyrone D
AU  - Cannon TD
AD  - Department of Psychology, Yale University, School of Medicine, New Haven, CT, 
      United States; Department of Psychiatry, Yale University, School of Medicine, New 
      Haven, CT, United States.
FAU - Keshavan, Matcheri
AU  - Keshavan M
AD  - Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical 
      Center and Massachusetts Mental Health Center, Boston, MA, United States.
FAU - Mathalon, Daniel H
AU  - Mathalon DH
AD  - Department of Psychiatry, University of California, San Francisco, United States.
FAU - McGlashan, Thomas H
AU  - McGlashan TH
AD  - Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, 
      United States.
FAU - Perkins, Diana O
AU  - Perkins DO
AD  - Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel 
      Hill, NC, United States.
FAU - Seidman, Larry
AU  - Seidman L
AD  - Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical 
      Center and Massachusetts Mental Health Center, Boston, MA, United States.
FAU - Stone, William
AU  - Stone W
AD  - Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical 
      Center and Massachusetts Mental Health Center, Boston, MA, United States.
FAU - Tsuang, Ming
AU  - Tsuang M
AD  - Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical 
      Center and Massachusetts Mental Health Center, Boston, MA, United States.
FAU - Walker, Elaine F
AU  - Walker EF
AD  - Department of Psychology, Emory University, Atlanta, GA, United States.
FAU - Woods, Scott W
AU  - Woods SW
AD  - Department of Psychiatry, Yale University, School of Medicine, New Haven, CT, 
      United States.
FAU - Torous, John
AU  - Torous J
AD  - Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical 
      Center and Massachusetts Mental Health Center, Boston, MA, United States.
FAU - Cornblatt, Barbara A
AU  - Cornblatt BA
AD  - Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, 
      Glen Oaks, NY, United States; Institute of Behavioral Science, Feinstein 
      Institute for Medical Research, Northwell Health, Manhasset, NY, United States; 
      Department of Psychiatry, Donald and Barbara Zucker School of Medicine at 
      Hofstra/Northwell, Hempstead, New York 11549, United States; Department of 
      Molecular Medicine, Donald and Barbara Zucker School of Medicine at 
      Hofstra/Northwell, Hempstead, New York 11549, United States. Electronic address: 
      BCornblatt@northwell.edu.
LA  - eng
GR  - U01 MH066069/MH/NIMH NIH HHS/United States
GR  - U01 MH082004/MH/NIMH NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20201031
PL  - Netherlands
TA  - Schizophr Res
JT  - Schizophrenia research
JID - 8804207
SB  - IM
MH  - Adolescent
MH  - Humans
MH  - Longitudinal Studies
MH  - *Prodromal Symptoms
MH  - *Psychotic Disorders
MH  - Social Adjustment
OTO - NOTNLM
OT  - Biobehavioral marker
OT  - Clinical high risk
OT  - Functional outcome
OT  - Psychosis
OT  - Role functioning
OT  - Social functioning
COIS- Declaration of competing interest The authors have declared that there are no 
      conflicts of interests in relation to the subject of this study.
EDAT- 2020/11/03 06:00
MHDA- 2021/06/22 06:00
CRDT- 2020/11/02 05:38
PHST- 2020/04/03 00:00 [received]
PHST- 2020/07/13 00:00 [revised]
PHST- 2020/09/11 00:00 [accepted]
PHST- 2020/11/03 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/11/02 05:38 [entrez]
AID - S0920-9964(20)30464-3 [pii]
AID - 10.1016/j.schres.2020.09.006 [doi]
PST - ppublish
SO  - Schizophr Res. 2021 Jan;227:44-51. doi: 10.1016/j.schres.2020.09.006. Epub 2020 
      Oct 31.