Reduced neurocognitive performance, functional impairments, and nonpositive mild symptoms at baseline appear to be associated with an increased risk of poor functional outcomes in patients at clinical high risk for psychosis, according to a study by Ricardo E. Carrion, Ph.D., of Zucker Hillside Hospital, Glen Oaks, N.Y., and colleagues.
A total of 101 treatment-seeking patients participated in the study to develop a model of functional (social and role) outcome in a clinical high-risk sample for psychosis, and 92 patients (91 percent) were followed up prospectively for an average of 3 years. The primary outcome variables were social and role functioning at the last follow-up visit.
Poor social outcome was predicted by reduced processing speed, impaired social functioning at baseline, and total disorganized symptoms. Reduced performance on tests for verbal memory, role functioning at baseline, and motor disturbances predicted role outcome. In addition, poor functional outcomes were not entirely dependent on the development of psychosis, because 40.3 percent and 45.5 percent of noncoverters at clinical high risk had poor social and role outcomes, respectively, according to the study results.
"Results from this study support the increasing emphasis on functional decline as a critically important outcome that parallels conversion to psychosis and suggests that both psychosis and long-term functional disability are equally important targets for prevention," the authors conclude.