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Predictors of social and role outcomes in first episode psychosis: A prospective 12‐month study of social cognition, neurocognition and symptoms
Author(s) -
Griffiths Sian Lowri,
Birchwood Max,
Khan Aneela,
Wood Stephen J.
Publication year - 2021
Publication title -
early intervention in psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.087
H-Index - 45
eISSN - 1751-7893
pISSN - 1751-7885
DOI - 10.1111/eip.13056
Subject(s) - psychosis , neurocognitive , social cognition , psychology , cognition , context (archaeology) , clinical psychology , psychological intervention , psychiatry , schizophrenia (object oriented programming) , theory of mind , paleontology , biology
Background Poor functioning is common in psychosis, with predictors of poor outcome including negative symptoms and deficits in neurocognition (NC) and social cognition (SC). The extent to which these variables contribute unique variance in social and role trajectories remains inconclusive. Identifying robust predictors of outcome will inform targeted interventions in early psychosis, where functional trajectories are being set. Method Prospective 12‐month follow‐up study investigating the predictive values of NC and SC on social and role functioning in individuals with first‐episode psychosis (FEP), within the context of clinical variables. 98 individuals with FEP (mean age = 24; male = 77) were assessed within the first year of diagnosis on functioning (social and role), cognition (SC and NC) and psychosis symptoms. Results Negative symptoms were the only significant predictor of 12‐month social (χ 2 = 9.59, P = .002, OR = 1.12) and role (χ 2 = 10.86, P < .001, OR = 1.16) functioning in FEP. In exploratory analyses, negative symptoms mediated the relationship between baseline social knowledge and social functioning ( Z = 1.92, P = .05; d = 0.56), and between baseline logical memory and role functioning ( Z = 2.40, P = .02; d = 0.80) at 12‐month follow‐up. Conclusion Although social and role trajectories in early psychosis appear somewhat distinct, negative symptoms were the best prognostic marker of social and role outcome in FEP, and mediated the relationship between SC and social outcome, and NC and role outcome; these relationships may be important when considering interventions to improve functional outcome in early psychosis.