Functional development in clinical high risk youth: Prediction of schizophrenia versus other psychotic disorders (original) (raw)
Social functioning in young people at risk for schizophrenia
Psychiatry Research, 2007
Deficits in social functioning are potential risk factors for schizophrenia. Social functioning was assessed in 55 individuals "at risk" for schizophrenia, 16 first episode patients with schizophrenia and 45 normal comparison subjects. The Social Adjustment Inventory for Children and Adolescents (SAICA) was administered to adolescents <18 and the Social Adjustment Scale (SAS-SR) to young adults >17. The at risk and first episode groups significantly differed from the normal subjects on measures of social functioning in the domains of peer, family, work and school relationships. Individuals at risk for schizophrenia have significant functional deficits which may be potential indicators of increased vulnerability for psychosis.
School Performance as a Premorbid Marker for Schizophrenia: A Twin Study
Schizophrenia Bulletin, 2002
Evidence is accumulating that developmental abnormalities, poor neuromotor function, and increased problem behavior precede the manifestation of schizophrenia itself. Information on school performance and behavioral development was obtained for 49 pairs of twins in which at least one twin suffered from schizophrenia (20 monozygotic [MZ], 29 dizygotic [DZ]) and for 43 pairs of healthy control twins (25 MZ, 18 DZ). Cox regression was used to analyze the contribution of schizophrenia, zygosity, sex, and year of birth to the age at which developmental divergence occurred. In both MZ and DZ twin pairs with schizophrenia, divergence in school performance occurred about 7.5 years earlier than it did in control twins, at 12 years of age, preceding the onset of psychosis by 10 years. This suggests that the first prodromal signs of schizophrenia manifest themselves as cognitive symptoms at the onset of puberty. Underperformance at school might therefore be considered one of the first signs of an until then latent vulnerability for schizophrenia.
Trajectories of cognitive development during adolescence among youth at-risk for schizophrenia
Journal of child psychology and psychiatry, and allied disciplines, 2018
Among adults with schizophrenia, evidence suggests that premorbid deficits in different cognitive domains follow distinct developmental courses during childhood and adolescence. The aim of this study was to delineate trajectories of adolescent cognitive functions prospectively among different groups of youth at-risk for schizophrenia, relative to their typically developing (TD) peers. Using linear mixed models adjusted for sex, ethnicity, parental occupation and practice effects, cognitive development between ages 9 and 16 years was compared for youth characterised by a triad of well-replicated developmental antecedents of schizophrenia (ASz; N = 32) and youth with a least one affected relative with schizophrenia or schizoaffective disorder (FHx; N = 29), relative to TD youth (N = 45). Participants completed measures of IQ, scholastic achievement, memory and executive function at three time-points, separated by approximately 24-month intervals. Compared to TD youth, both ASz and FHx...
Social functioning deficits in young people at risk for schizophrenia
Australasian …, 2008
Objective: Impairment in social functioning is a central feature of schizophrenia and is known to be evident before the onset of psychosis, acting as a potential vulnerability marker. The aim of the present study was to test the hypothesis that social impairment is simultaneously a state and trait marker of risk for schizophrenia and schizophrenia-related disorder. Method: Social functioning was examined in three groups: ultra-high-risk subjects (UHR, n=32), genetic high-risk subjects (GHR, n=32), and age- and IQ-matched healthy controls (HC, n=30). Social functioning was assessed using the Social Functioning Scale (SFS), and prodromal symptoms were assessed in high-risk subjects using the Comprehensive Assessment of At-Risk Mental States (CAARMS). Results: Both the UHR and GHR groups exhibited significantly impaired social functioning compared with the HC group, and the UHR group was more impaired than the GHR group. In the UHR group, duration of prodromal symptoms was related to impaired ‘interpersonal behaviour’. Positive and negative symptoms were not significantly associated with social functioning, whereas disorganized and general symptoms were significantly correlated with poor ‘independencecompetence’ in UHR individuals. Conclusion: The findings support the hypothesis that impairment in social functioning is both a trait and state marker of risk for schizophrenia and other psychotic disorders, implying that social impairment constitutes a mediating vulnerability indicator of psychotic disorders including schizophrenia
Acta Psychiatrica Scandinavica, 2018
academic and social functioning in patients with schizophrenia and its associations with negative symptoms and cognition. Objective: The study aimed to explore premorbid academic and social functioning in patients with schizophrenia, and its associations with the severity of negative symptoms and neurocognitive impairment. Method: Premorbid adjustment (PA) in patients with schizophrenia was compared to early adjustment in unaffected first-degree relatives and healthy controls. Its associations with psychopathology, cognition, and real-life functioning were investigated. The associations of PA with primary negative symptoms and their two factors were explored. Results: We found an impairment of academic and social PA in patients (P ≤ 0.000001) and an impairment of academic aspects of early adjustment in relatives (P ≤ 0.01). Patients with poor PA showed greater severity of negative symptoms (limited to avolition after excluding the effect of depression/parkinsonism), working memory, social cognition, and real-life functioning (P ≤ 0.01 to ≤0.000001). Worse academic and social PA were associated with greater severity of psychopathology, cognitive impairment, and real-life functioning impairment (P ≤ 0.000001). Regression analyses showed that worse PA in the academic domain was mainly associated to the impairment of working memory, whereas worse PA in the social domain to avolition (P ≤ 0.000001). Conclusion: Our findings suggest that poor early adjustment may represent a marker of vulnerability to schizophrenia and highlight the need for preventive/early interventions based on psychosocial and/or cognitive programs.
Developmental Trajectories of Impaired Community Functioning in Schizophrenia
JAMA psychiatry, 2015
Community functioning is a core component of the functional deficits in schizophrenia, yet little systematic research on the origins of these functional deficits has been performed. To examine 3 key domains of community functioning-social activity, independent behavior, and functioning in school or work-before first hospitalization for schizophrenia and to determine whether these domains are familial. In this population-based, prospective study that included a sibling-control comparison, data from the Israeli National Draft Board Registry were linked with data from the Israeli Psychiatric Hospitalization Case Registry. The merged file included data for all male adolescents who visited the draft board and were followed up for as much as 25.4 years from draft board assessment (through the end of 2010). The 3 functional domains for cases, their unaffected siblings, and controls were compared by time between assessment and time to hospitalization. Analyses were conducted from March 13, ...
Schizophrenia research, 2005
Kraepelin and Blueler suggested that subtle manifestations of schizophrenia are present in some persons for many years before formal diagnosis and that the severity of these is associated with outcomes in schizophrenia. Empirical support for this hypothesis comes primarily from small samples using retrospectively collected data. We tested this hypothesis, for the first time, using a population-based cohort. The Israeli Draft Board Registry, which contains measures of intellectual and behavioral functioning for the unselected population of 17-year-olds, was merged with the National Psychiatric Hospitalization Case Registry that contains data on all psychiatric hospitalizations. The database was used to identify adolescents assessed by the draft board at least 1 year prior to their first hospitalization for schizophrenia (n=996) or affective disorder (n=335). Poorer social functioning and organizational ability prior to first admission were associated with more days per year in the ho...
Predictive factors in early onset schizophrenia
Experimental and Therapeutic Medicine, 2020
Schizophrenia is a neurodevelopmental disorder, characterized by impairment in reasoning, affectivity and social relationships. Although the diagnosis of schizophrenia in children and adolescents has been challenged for many years, at present childhood-onset schizophrenia is considered and accepted as a clinical and biological continuum with the adult-onset disorder. The present study aimed to evaluate the influence of biological (psychiatric family history, perinatal factors), and socio-demographic factors (area of residence, gender) on the age at onset and severity of symptomatology in children and adolescent with schizophrenia. The data were collected from 2016 to 2019 and included 148 children and adolescents with schizophrenia. Data were analysed with statistical software (IBM SPSS 22, JASP and JAMOVI, Linear Regression Model, χ² tests, t-test, U-test). A positive familial history for psychiatric diseases was an important risk factor both for an early onset and for the severity of symptoms. Urbanicity was another studied risk factor, 61% of patients being from urban areas; no statistically significant correlations between urbanicity and age at onset and severity of symptoms were identified. There was no statistically significant gender difference in terms of age at onset and severity of symptoms. Moreover, no statistically significant correlations were found between perinatal factors and age at onset and severity of symptoms. Positive psychiatric family history showed a statistically significant influence on age at onset and symptoms severity in children and adolescent schizophrenia; no statistical significant impact on the aforementioned schizophrenia aspects was observed for urbanicity, gender or perinatal factors.
Schizophrenia research, 2012
Population-based studies of cognitive and behavioral premorbid functioning in psychotic disorders generally focus on late adolescence in schizophrenia and most are based on IQ test scores. To examine differences in school grades at the ages of 13-14 between persons hospitalized during adulthood for schizophrenia or affective disorders and their peers. Ten years of school report data were ascertained on 8th grade children (n=21,448) in the city of Jerusalem (1978-1988). During adulthood cases with schizophrenia (n=194, 0.9%) or an affective disorder (n=41, 0.19%) were identified based on psychiatric hospitalizations in the National Psychiatric Hospitalization Case Registry of the State of Israel. School assessments of academic performance, nonacademic topics, and teacher ratings of classroom behavior were compared between peers without illness and cases, and their association with illness was examined. Children subsequently hospitalized with schizophrenia had significantly lower nona...
2003
Evidence is accumulating that developmental abnor-malities, poor neuromotor function, and increased problem behavior precede the manifestation of schizo-phrenia itself. Information on school performance and behavioral development was obtained for 49 pairs of twins in which at least one twin suffered from schizo-phrenia (20 monozygotic [MZ], 29 dizygotic [DZ]) and for 43 pairs of healthy control twins (25 MZ, 18 DZ). Cox regression was used to analyze the contribution of schizophrenia, zygosity, sex, and year of birth to the age at which developmental divergence occurred. In both MZ and DZ twin pairs with schizophrenia, diver-gence in school performance occurred about 7.5 years earlier than it did in control twins, at 12 years of age, preceding the onset of psychosis by 10 years. This sug-gests that the first prodromal signs of schizophrenia manifest themselves as cognitive symptoms at the onset of puberty. Underperformance at school might therefore be considered one of the first sig...