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Potentially important periods of change in the development of social and role functioning in youth at clinical high risk for psychosis

Published online by Cambridge University Press:  19 April 2017

Eva Velthorst*
Affiliation:
Icahn School of Medicine at Mount Sinai University of Amsterdam
Jamie Zinberg
Affiliation:
University of California, Los Angeles
Jean Addington
Affiliation:
University of Calgary
Kristin S. Cadenhead
Affiliation:
University of California, San Diego
Tyrone D. Cannon
Affiliation:
Yale University
Ricardo E. Carrión
Affiliation:
Hofstra Northwell School of Medicine
Andrea Auther
Affiliation:
Hofstra Northwell School of Medicine
Barbara A. Cornblatt
Affiliation:
Hofstra Northwell School of Medicine
Thomas H. McGlashan
Affiliation:
Yale University
Daniel H. Mathalon
Affiliation:
University of California, San Francisco San Francisco VA Medical Center
Diana O. Perkins
Affiliation:
University of North Carolina, Chapel Hill
Larry J. Seidman
Affiliation:
Harvard Medical School at Beth Israel Deaconess Medical Center Massachusetts General Hospital
Ming T. Tsuang
Affiliation:
University of California, San Diego
Elaine F. Walker
Affiliation:
Emory University
Scott W. Woods
Affiliation:
Yale University
Abraham Reichenberg
Affiliation:
Icahn School of Medicine at Mount Sinai
Carrie E. Bearden
Affiliation:
University of California, Los Angeles
*
Address correspondence and reprint requests to: Eva Velthorst, Department of Psychiatry and Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, New York, NY 10029; E-mail: eva.velthorst@mssm.edu.

Abstract

The developmental course of daily functioning prior to first psychosis-onset remains poorly understood. This study explored age-related periods of change in social and role functioning. The longitudinal study included youth (aged 12–23, mean follow-up years = 1.19) at clinical high risk (CHR) for psychosis (converters [CHR-C], n = 83; nonconverters [CHR-NC], n = 275) and a healthy control group (n = 164). Mixed-model analyses were performed to determine age-related differences in social and role functioning. We limited our analyses to functioning before psychosis conversion; thus, data of CHR-C participants gathered after psychosis onset were excluded. In controls, social and role functioning improved over time. From at least age 12, functioning in CHR was poorer than in controls, and this lag persisted over time. Between ages 15 and 18, social functioning in CHR-C stagnated and diverged from that of CHR-NC, who continued to improve (p = .001). Subsequently, CHR-C lagged behind in improvement between ages 21 and 23, further distinguishing them from CHR-NC (p < .001). A similar period of stagnation was apparent for role functioning, but to a lesser extent (p = .007). The results remained consistent when we accounted for the time to conversion. Our findings suggest that CHR-C start lagging behind CHR-NC in social and role functioning in adolescence, followed by a period of further stagnation in adulthood.

Type
Regular Articles
Copyright
Copyright © Cambridge University Press 2017 

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Footnotes

This study was supported by grants from the National Institute of Mental Health of the National Institutes of Health (U01 MH081928 to L.J.S., U01 MH066134 to J.A., R01 MH60720 to K.S.C., R01 MH065079 to T.D.C., R01 MH061523 to B.A.C., U01 MH066069 and K23 MH001905 to D.O.P., RO1MH062066 to E.F.W., U01 MH066160 to S.W.W., and K05MH01654 to T.H.M.), the Commonwealth of Massachusetts (SCDMH82101008006 to L.J.S), and the Netherlands Organization for Scientific Research (VENI 916-15-005 to E.V.). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors have no conflicts of interest in relation to the subject of this study.

References

Addington, J., Cadenhead, K. S., Cannon, T. D., Cornblatt, B., McGlashan, T. H., Perkins, D. O., … North American Prodrome Longitudinal Study. (2007). North American prodrome longitudinal study: A collaborative multisite approach to prodromal schizophrenia research. Schizophrenia Bulletin, 33, 665672. doi:sbl075 Google Scholar
Addington, J., Cornblatt, B. A., Cadenhead, K. S., Cannon, T. D., McGlashan, T. H., Perkins, D. O., … Heinssen, R. (2011). At clinical high risk for psychosis: Outcome for nonconverters. American Journal of Psychiatry, 168, 800805. doi:10.1176/appi.ajp.2011.10081191 Google Scholar
Addington, J., Epstein, I., Liu, L., French, P., Boydell, K. M., & Zipursky, R. B. (2011). A randomized controlled trial of cognitive behavioral therapy for individuals at clinical high risk of psychosis. Schizophrenia Research, 125, 5461. doi:10.1016/j.schres.2010.10.015 CrossRefGoogle ScholarPubMed
Allen, D. N., Frantom, L. V., Strauss, G. P., & van Kammen, D. P. (2005). Differential patterns of premorbid academic and social deterioration in patients with schizophrenia. Schizophrenia Research, 75, 389397. doi:10.1016/j.schres.2004.11.011 Google Scholar
Almerie, M. Q., Okba Al Marhi, M., Jawoosh, M., Alsabbagh, M., Matar, H. E., Maayan, N., & Bergman, H. (2015). Social skills programmes for schizophrenia. Cochrane Database of Systematic Reviews, 6, CD009006. doi:10.1002/14651858.CD009006.pub2 Google Scholar
Burns, T., & Patrick, D. (2007). Social functioning as an outcome measure in schizophrenia studies. Acta Psychiatrica Scandinavica, 116, 403418. doi:ACP1108 Google Scholar
Cannon, T. D., Cadenhead, K., Cornblatt, B., Woods, S. W., Addington, J., Walker, E., … Heinssen, R. (2008). Prediction of psychosis in youth at high clinical risk: A multisite longitudinal study in North America. Archives of General Psychiatry, 65, 2837. doi:10.1001/archgenpsychiatry.2007.3 Google Scholar
Carrion, R. E., McLaughlin, D., Goldberg, T. E., Auther, A. M., Olsen, R. H., Olvet, D. M., … Cornblatt, B. A. (2013). Prediction of functional outcome in individuals at clinical high risk for psychosis. JAMA Psychiatry, 70, 11331142. doi:10.1001/jamapsychiatry.2013.1909 CrossRefGoogle ScholarPubMed
Cole, V. T., Apud, J. A., Weinberger, D. R., & Dickinson, D. (2012). Using latent class growth analysis to form trajectories of premorbid adjustment in schizophrenia. Journal of Abnormal Psychology, 121, 388395. doi:10.1037/a0026922 CrossRefGoogle ScholarPubMed
Cornblatt, B. A., Auther, A. M., Niendam, T., Smith, C. W., Zinberg, J., Bearden, C. E., & Cannon, T. D. (2007). Preliminary findings for two new measures of social and role functioning in the prodromal phase of schizophrenia. Schizophrenia Bulletin, 33, 688702. doi:10.1093/schbul/sbm029 Google Scholar
Cornblatt, B. A., Carrion, R. E., Addington, J., Seidman, L., Walker, E. F., Cannon, T. D., … Lencz, T. (2012). Risk factors for psychosis: Impaired social and role functioning. Schizophrenia Bulletin, 38, 12471257. doi:10.1093/schbul/sbr136 Google Scholar
Cotter, J., Drake, R. J., Bucci, S., Firth, J., Edge, D., & Yung, A. R. (2014). What drives poor functioning in the at-risk mental state? A systematic review. Schizophrenia Research, 159, 267277. doi:10.1016/j.schres.2014.09.012 CrossRefGoogle ScholarPubMed
First, M., Spitzer, R., Gibbon, M., & Williams, J. (1997). Structured Clinical Interview for DSM-IV axis I disorders (SCID)—Clinician version. Washington, DC: American Psychiatric Press.Google Scholar
French, P., & Morrison, A. P. (2004). Early detection and cognitive therapy for people at high risk of developing psychosis: A treatment approach. Chichester: Wiley.Google Scholar
Garmezy, N., & Rodnick, E. H. (1959). Premorbid adjustment and performance in schizophrenia: Implications for interpreting heterogeneity in schizophrenia. Journal of Nervous and Mental Disease, 129, 450466.CrossRefGoogle ScholarPubMed
Green, M. F., Llerena, K., & Kern, R. S. (2015). The “right stuff” revisited: What have we learned about the determinants of daily functioning in schizophrenia? Schizophrenia Bulletin, 41, 781785. doi:10.1093/schbul/sbv018 Google Scholar
Hafner, H., Loffler, W., Maurer, K., Hambrecht, M., & an der Heiden, W. (1999). Depression, negative symptoms, social stagnation and social decline in the early course of schizophrenia. Acta Psychiatrica Scandinavica, 100, 105118.CrossRefGoogle ScholarPubMed
Hafner, H., Nowotny, B., Loffler, W., an der Heiden, W., & Maurer, K. (1995). When and how does schizophrenia produce social deficits? European Archives of Psychiatry and Clinical Neuroscience, 246, 1728.Google Scholar
Harvey, P. D., Sabbag, S., Prestia, D., Durand, D., Twamley, E. W., & Patterson, T. L. (2012). Functional milestones and clinician ratings of everyday functioning in people with schizophrenia: Overlap between milestones and specificity of ratings. Journal of Psychiatric Research, 46, 15461552. doi:10.1016/j.jpsychires.2012.08.018 Google Scholar
Hodgekins, J., Birchwood, M., Christopher, R., Marshall, M., Coker, S., Everard, L., … Fowler, D. (2015). Investigating trajectories of social recovery in individuals with first-episode psychosis: A latent class growth analysis. British Journal of Psychiatry, 207, 536543. doi:10.1192/bjp.bp.114.153486 Google Scholar
Horton, L. E., Tarbox, S. I., Olino, T. M., & Haas, G. L. (2015). Trajectories of premorbid childhood and adolescent functioning in schizophrenia-spectrum psychoses: A first-episode study. Psychiatry Research, 227, 339346. doi:10.1016/j.psychres.2015.02.013 Google Scholar
Landa, Y., Mueser, K. T., Wyka, K. E., Shreck, E., Jespersen, R., Jacobs, M. A., … Walkup, J. T. (2016). Development of a group and family-based cognitive behavioural therapy program for youth at risk for psychosis. Early Intervention in Psychiatry, 10, 511521. doi:10.1111/eip.12204 CrossRefGoogle ScholarPubMed
Lin, A., Wood, S. J., & Yung, A. R. (2013). Measuring psychosocial outcome is good. Current Opinion in Psychiatry, 26, 138143. doi:10.1097/YCO.0b013e32835d82aa Google Scholar
McGlashan, T., Walsh, B. C., & Woods, S. W. (2010). The psychosis risk syndrome: Handbook for diagnosis and follow-up. New York: Oxford University Press.Google Scholar
Meier, M. H., Caspi, A., Reichenberg, A., Keefe, R. S., Fisher, H. L., Harrington, H., … Moffitt, T. E. (2014). Neuropsychological decline in schizophrenia from the premorbid to the postonset period: Evidence from a population-representative longitudinal study. American Journal of Psychiatry, 171, 91101. doi:10.1176/appi.ajp.2013.12111438 Google Scholar
Meyer, E. C., Carrion, R. E., Cornblatt, B. A., Addington, J., Cadenhead, K. S., Cannon, T. D., … NAPLS Group. (2014). The relationship of neurocognition and negative symptoms to social and role functioning over time in individuals at clinical high risk in the first phase of the North American prodrome longitudinal study. Schizophrenia Bulletin, 40, 14521461. doi:10.1093/schbul/sbt235 Google Scholar
Meyer, S. E., Bearden, C. E., Lux, S. R., Gordon, J. L., Johnson, J. K., O'Brien, M. P., … Cannon, T. D. (2005). The psychosis prodrome in adolescent patients viewed through the lens of DSM-IV. Journal of Child and Adolescent Psychopharmacology, 15, 434451. doi:10.1089/cap.2005.15.434 Google Scholar
Monte, R. C., Goulding, S. M., & Compton, M. T. (2008). Premorbid functioning of patients with first-episode nonaffective psychosis: A comparison of deterioration in academic and social performance, and clinical correlates of premorbid adjustment scale scores. Schizophrenia Research, 104, 206213. doi:10.1016/j.schres.2008.06.009 CrossRefGoogle ScholarPubMed
Murray, R. M., O'Callaghan, E., Castle, D. J., & Lewis, S. W. (1992). A neurodevelopmental approach to the classification of schizophrenia. Schizophrenia Bulletin, 18, 319332.Google Scholar
Nelson, B., Yuen, H. P., Wood, S. J., Lin, A., Spiliotacopoulos, D., Bruxner, A., … Yung, A. R. (2013). Long-term follow-up of a group at ultra high risk (“prodromal”) for psychosis: The PACE 400 Study. JAMA Psychiatry, 70, 793802. doi:10.1001/jamapsychiatry.2013.1270 Google Scholar
Okuzawa, N., Kline, E., Fuertes, J., Negi, S., Reeves, G., Himelhoch, S., & Schiffman, J. (2014). Psychotherapy for adolescents and young adults at high risk for psychosis: A systematic review. Early Intervention in Psychiatry, 8, 307322. doi:10.1111/eip.12129 Google Scholar
Phillips, L. (1953). Case history data and prognosis in schizophrenia. Journal of Nervous and Mental Disease, 117, 515525.CrossRefGoogle ScholarPubMed
Reichenberg, A., Caspi, A., Harrington, H., Houts, R., Keefe, R. S., Murray, R. M., … Moffitt, T. E. (2010). Static and dynamic cognitive deficits in childhood preceding adult schizophrenia: A 30-year study. American Journal of Psychiatry, 167, 160169. doi:10.1176/appi.ajp.2009.09040574 Google Scholar
Schmidt-Kastner, R., van Os, J., Esquivel, G., Steinbusch, H. W., & Rutten, B. P. (2012). An environmental analysis of genes associated with schizophrenia: Hypoxia and vascular factors as interacting elements in the neurodevelopmental model. Molecular Psychiatry, 17, 11941205. doi:10.1038/mp.2011.183 CrossRefGoogle ScholarPubMed
Seidman, L. J., Giuliano, A. J., Meyer, E. C., Addington, J., Cadenhead, K. S., Cannon, T. D., … North American Prodrome Longitudinal Study (NAPLS) Group. (2010). Neuropsychology of the prodrome to psychosis in the NAPLS consortium: Relationship to family history and conversion to psychosis. Archives of General Psychiatry, 67, 578588. doi:10.1001/archgenpsychiatry.2010.66 Google Scholar
Selemon, L. D., & Zecevic, N. (2015). Schizophrenia: A tale of two critical periods for prefrontal cortical development. Translational Psychiatry, 5, e623. doi:10.1038/tp.2015.115 Google Scholar
Shapiro, D. I., Marenco, S., Spoor, E. H., Egan, M. F., Weinberger, D. R., & Gold, J. M. (2009). The premorbid adjustment scale as a measure of developmental compromise in patients with schizophrenia and their healthy siblings. Schizophrenia Research, 112, 136142. doi:10.1016/j.schres.2009.04.007 Google Scholar
StataCorp. (2014). Stata statistical software: Release 14 [Computer software]. College Station, TX: Author.Google Scholar
Stone, W. S., Mesholam-Gately, R. I., Giuliano, A. J., Woodberry, K. A., Addington, J., Bearden, C. E., … Seidman, L. J. (2016). Healthy adolescent performance on the MATRICS consensus cognitive battery (MCCB): Developmental data from two samples of volunteers. Schizophrenia Research. Advance online publication. doi:S0920-9964(16)30059-7 Google Scholar
Strauss, G. P., Allen, D. N., Miski, P., Buchanan, R. W., Kirkpatrick, B., & Carpenter, W. T. Jr. (2012). Differential patterns of premorbid social and academic deterioration in deficit and nondeficit schizophrenia. Schizophrenia Research, 135, 134138. doi:10.1016/j.schres.2011.11.007 Google Scholar
Thompson, E., Millman, Z. B., Okuzawa, N., Mittal, V., DeVylder, J., Skadberg, T., … Schiffman, J. (2015). Evidence-based early interventions for individuals at clinical high risk for psychosis: A review of treatment components. Journal of Nervous and Mental Disease, 203, 342351. doi:10.1097/NMD.0000000000000287 Google Scholar
van der Gaag, M., Nieman, D. H., Rietdijk, J., Dragt, S., Ising, H. K., Klaassen, R. M., … Linszen, D. H. (2012). Cognitive behavioral therapy for subjects at ultrahigh risk for developing psychosis: A randomized controlled clinical trial. Schizophrenia Bulletin, 38, 11801188. doi:10.1093/schbul/sbs105 Google Scholar
van der Gaag, M., Smit, F., Bechdolf, A., French, P., Linszen, D. H., Yung, A. R., … Cuijpers, P. (2013). Preventing a first episode of psychosis: Meta-analysis of randomized controlled prevention trials of 12 month and longer-term follow-ups. Schizophrenia Research, 149, 5662. doi:10.1016/j.schres.2013.07.004 Google Scholar
Velthorst, E., Nieman, D. H., Becker, H. E., van de Fliert, R., Dingemans, P. M., Klaassen, R., … Linszen, D. H. (2009). Baseline differences in clinical symptomatology between ultra high risk subjects with and without a transition to psychosis. Schizophrenia Research, 109, 6065. doi:10.1016/j.schres.2009.02.002 Google Scholar
Velthorst, E., Nieman, D. H., Linszen, D., Becker, H., de Haan, L., Dingemans, P. M., … Ruhrmann, S. (2010). Disability in people clinically at high risk of psychosis. British Journal of Psychiatry, 197, 278284. doi:10.1192/bjp.bp.109.075036 Google Scholar
Velthorst, E., Reichenberg, A., Kapara, O., Goldberg, S., Fromer, M., Fruchter, E., … Weiser, M. (2015). Developmental trajectories of impaired community functioning in schizophrenia. JAMA Psychiatry. Advance online publication.Google Scholar
Wechsler, D. (1981). Manual for the Wechsler Adult Intelligence Scale—Revised (WAIS-R). San Antonio, TX: Psychological Corp.Google Scholar
Wechsler, D. (1991). Wechsler Intelligence Scale for Children (3rd ed.). San Antonio, TX: Psychological Corp.Google Scholar
Weinberger, D. R. (1987). Implications of normal brain development for the pathogenesis of schizophrenia. Archives of General Psychiatry, 44, 660669.Google Scholar