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Disability in people clinically at high risk of psychosis

  • Eva Velthorst (a1), Dorien H. Nieman (a1), Don Linszen (a1), Hiske Becker (a1), Lieuwe de Haan (a1), Peter M. Dingemans (a2), Max Birchwood (a3), Paul Patterson (a3), Raimo K. R. Salokangas (a4), Markus Heinimaa (a4), Andreas Heinz (a5), Georg Juckel (a6), Heinrich Graf von Reventlow (a7), Paul French (a8), Helen Stevens (a9), Frauke Schultze-Lutter (a10), Joachim Klosterkötter (a11) and Stephan Ruhrmann (a11)...

Abstract

Background

Decline in social functioning occurs in individuals who later develop psychosis.

Aims

To investigate whether baseline differences in disability are present in those who do and those who do not make a transition to psychosis in a group clinically at high risk and whether disability is a risk factor for transition.

Method

Prospective multicentre, naturalistic field study with an 18-month follow-up period on 245 help-seeking individuals clinically at high risk. Disability was assessed with the Disability Assessment Schedule of the World Health Organization (WHODAS–II).

Results

At baseline, the transition group displayed significantly greater difficulties in making new friends (z =−3.40, P = 0.001), maintaining a friendship (z =−3.00, P = 0.003), dealing with people they do not know (z =−2.28, P = 0.023) and joining community activities (z =−2.0, P = 0.05) compared with the non-transition group. In Cox regression, difficulties in getting along with people significantly contributed to the prediction of transition to psychosis in our sample (β = 0.569, s.e. = 0.184, Wald = 9.548, P = 0.002, hazard ratio (HR) = 1.767, 95% CI 1.238–2.550).

Conclusions

Certain domains of social disability might contribute to the prediction of psychosis in a sample clinically at high risk.

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Copyright

Corresponding author

D. Linszen, MD, PhD, Academic Medical Center, Department of Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands. Email: d.h.linszen@amc.uva.nl

Footnotes

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This study was funded within the 5th Framework Programme ‘Quality of Life and Management of Living Resources' of the European Commission, Action line 10.1 ‘Public Health’ (grant QLG4-CT-2001-01081). Additional local funding was provided by the Health Research Council of The Netherlands (ZorgOnderzoek Nederland/NWO-Medische Wetenschappen, project # 2630.0001), the Social Insurance Institution of Finland (Dnro 12-26-2006) and by the Medical Faculty of Cologne (Köln Fortune Program).

Declaration of interest

None.

Footnotes

References

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Disability in people clinically at high risk of psychosis

  • Eva Velthorst (a1), Dorien H. Nieman (a1), Don Linszen (a1), Hiske Becker (a1), Lieuwe de Haan (a1), Peter M. Dingemans (a2), Max Birchwood (a3), Paul Patterson (a3), Raimo K. R. Salokangas (a4), Markus Heinimaa (a4), Andreas Heinz (a5), Georg Juckel (a6), Heinrich Graf von Reventlow (a7), Paul French (a8), Helen Stevens (a9), Frauke Schultze-Lutter (a10), Joachim Klosterkötter (a11) and Stephan Ruhrmann (a11)...
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