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Open Access 01-12-2021 | Research

Short-term functional outcome in psychotic patients: results of the Turku early psychosis study (TEPS)

Authors: Raimo K. R. Salokangas, Tiina From, Tuula Ilonen, Sinikka Luutonen, Markus Heinimaa, Reetta-Liina Armio, Heikki Laurikainen, Maija Walta, Janina Paju, Anna Toivonen, Päivi Jalo, Lauri Tuominen, Jarmo Hietala

Published in: BMC Psychiatry | Issue 1/2021

Abstract

Background

Functional recovery of patients with clinical and subclinical psychosis is associated with clinical, neuropsychological and developmental factors. Less is known about how these factors predict functional outcomes in the same models. We investigated functional outcomes and their predictors in patients with first-episode psychosis (FEP) or a confirmed or nonconfirmed clinical high risk of psychosis (CHR-P vs. CHR-N).

Methods

Altogether, 130 patients with FEP, 60 patients with CHR-P and 47 patients with CHR-N were recruited and extensively examined at baseline (T0) and 9 (T1) and 18 (T2) months later. Global Assessment of Functioning (GAF) at T0, T1 and T2 and psychotic, depression, and anxiety symptoms at T1 and T2 were assessed. Functional outcomes were predicted using multivariate repeated ANOVA.

Results

During follow-up, the GAF score improved significantly in patients with FEP and CHR-P but not in patients with CHR-N. A single marital status, low basic education level, poor work situation, disorganization symptoms, perceptual deficits, and poor premorbid adjustment in patients with FEP, disorganization symptoms and poor premorbid adjustment in patients with CHR-P, and a low basic education level, poor work situation and general symptoms in patients with CHR-N predicted poor functional outcomes. Psychotic symptoms at T1 in patients with FEP and psychotic and depression symptoms at T1 and anxiety symptoms at T2 in patients with CHR-P were associated with poor functioning.

Conclusions

In patients with FEP and CHR-P, poor premorbid adjustment and disorganization symptomatology are common predictors of the functional outcome, while a low education level and poor work situation predict worse functional outcomes in patients with FEP and CHR-N. Interventions aimed at improving the ability to work and study are most important in improving the functioning of patients with clinical or subclinical psychosis.

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WHO. The Global Burden of Disease: Update 2008. http://www.who.int/topics/global_burden_of_disease/en/ Assessed 22 Mar 2021.

Gustavsson A, Svensson M, Jacobi F, Allgulander C, Alonso J, Beghi E, et al. CDBE2010 study group. Cost of disorders of the brain in Europe 2010. Eur Neuropsychopharmacol. 2011;21(10):718–79. https://doi.org/10.1016/j.euroneuro.2011.08.008.CrossRefPubMed

Saha S, Chant D, McGrath J. A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time? Arch Gen Psychiatry. 2007;64(10):1123–31. 17909124. https://doi.org/10.1001/archpsyc.64.10.1123.CrossRefPubMed

Kelly C, McCreadie RG, MacEwan T, Carey S. Nithsdale schizophrenia surveys. 17. Fifteen year review. Br J Psychiatry. 1998;172(6):513–7. 9828992. https://doi.org/10.1192/bjp.172.6.513.CrossRefPubMed

Jääskeläinen E, Juola P, Hirvonen N, et al. A systematic review and meta-analysis of recovery in schizophrenia. Schizophr Bull. 2013;39(6):1296–306. https://doi.org/10.1093/schbul/sbs130 Epub 2012 Nov 20. PMID: 23172003; PMCID: PMC3796077.CrossRefPubMed

Brown S, Birtwistle J, Roe L, Thompson C. The unhealthy lifestyle of people with schizophrenia. Psychol Med. 1999;29(3):697–701. https://doi.org/10.1017/s0033291798008186 PMID: 10405091.CrossRefPubMed

Honkonen T, Stengård E, Virtanen M, Salokangas RK. Employment predictors for discharged schizophrenia patients. Soc Psychiatry Psychiatr Epidemiol. 2007;42(5):372–80. https://doi.org/10.1007/s00127-007-0180-5 Epub 2007 Mar 19. PMID: 17492406.CrossRefPubMed

Jobe TH, Harrow M. Long-term outcome of patients with schizophrenia: a review. Can J Psychiatr. 2005;50(14):892–900. 16494258. https://doi.org/10.1177/070674370505001403.CrossRef

Vaillant GE. The prediction of recovery in schizophrenia. J Nerv Ment Dis. 1962;135(6):534–43. https://doi.org/10.1097/00005053-196212000-00006 PMID: 13995749.CrossRefPubMed

10.

Astrup C, Noreik K. Functional psychoses. Diagnostic and prognostic models. Springfield: Charles C Thomas; 1966. p. 176.

11.

Noreik K, Astrup C, Dalgard OS, Holmboe R. A prolonged follow-up of acute schizophrenic and schizophreniform psychoses. Acta Psychiatr Scand. 1967;43(4):432–43. https://doi.org/10.1111/j.1600-0447.1967.tb05780.x.CrossRefPubMed

12.

Stephens JH, Astrup C, Mangrum JC. Prognosis in schizophrenia. Prognostic scales cross validated in American and Norwegian patients. Arch Gen Psychiatry. 1967;16(6):693–8. https://doi.org/10.1001/archpsyc.1967.01730240049008 PMID: 6027367.CrossRefPubMed

13.

Stephens JH. Long-term prognosis and follow up in schizophrenia. Schizophr Bull. 1978;4(1):25–47. https://doi.org/10.1093/schbul/4.1.25 PMID: 34208.CrossRefPubMed

14.

Salokangas RKR. Skitsofreniaan sairastuneiden psykososiaalinen kehitys. (English summary: the psychosocial development of schizophrenic patients.) Kansaneläkelaitoksen julkaisuja AL 7. Turku: Kansaneläkelaitos; 1977.

15.

Salokangas RKR. Psychosocial prognosis in schizophrenia. Formation of the prognosis for schizophrenic patients: a multivariate analysis. Annales Universitatis Turkuensis. Ser. D. Turku: University of Turku; 1978.

16.

Salokangas RK. Prognostic implications of the sex of schizophrenic patients. Br J Psychiatry. 1983;142(2):145–51. https://doi.org/10.1192/bjp.142.2.145 PMID: 6839067.CrossRefPubMed

17.

Salokangas RKR. Skitsofrenian hoito ja ennuste. (English Summary: Treatment and outcome in schizophrenia. Kansanterveystieteen julkaisuja M 89/85. University of Tampere Community Health Institute, University of Turku. Tampere; 1985.

18.

Salokangas RK, Stengård E. Gender and short-term outcome in schizophrenia. Schizophr Res. 1990;3(5–6):333–45. https://doi.org/10.1016/0920-9964(90)90019-4 PMID: 2282339.CrossRefPubMed

19.

Salokangas RKR, Stengård E, Räkköläinen V, Alanen YO, Kaljonen A. Treatment and Outcome of New Patients with Schizophrenia. Five-year Outcome [NSP project] (In Finnish: Uusien skitsofreniapotilaiden hoito ja ennuste [USP-projekti] V: Viiden vuoden ennuste. Reports of Psychiatria Fennica No 95. Helsinki; 1991.

20.

Möller HJ, von Zerssen D. Course and outcome. In: Hirsch SR, Weinberger DR, editors. Schizophrenia. Oxford: Blackwell Science; 1995. p. 106–27.

21.

Green MF, Kern RS, Braff DL, Mintz J. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the “right stuff”? Schizophr Bull. 2000;26(1):119–36. https://doi.org/10.1093/oxfordjournals.schbul.a033430 PMID: 10755673.CrossRefPubMed

22.

White C, Stirling J, Hopkins R, Morris J, Montague L, Tantam D, et al. Predictors of 10-year outcome of first-episode psychosis. Psychol Med. 2009;39(9):1447–56. https://doi.org/10.1017/S003329170800514X Epub 2009 Feb 3. PMID: 19187566.CrossRefPubMed

23.

Pantelis C, Yücel M, Wood SJ, McGorry PD, Velakoulis D. Early and late neurodevelopmental disturbances in schizophrenia and their functional consequences. Aust N Z J Psychiatry. 2003;37(4):399–406. https://doi.org/10.1046/j.1440-1614.2003.01193.x PMID: 12873323.CrossRefPubMed

24.

Carpenter WT, Bustillo JR, Thaker GK, van Os J, Krueger RF, Green MJ. The psychoses: cluster 3 of the proposed meta-structure for DSM-V and ICD-11. Psychol Med. 2009;39(12):2025–42. https://doi.org/10.1017/S0033291709990286 Epub 2009 Oct 1. PMID: 19796428.CrossRefPubMed

25.

Rosell DR, Futterman SE, McMaster A, Siever LJ. Schizotypal personality disorder: a current review. Curr Psychiatry Rep. 2014;16(7):452. https://doi.org/10.1007/s11920-014-0452-1 PMID: 24828284; PMCID: PMC4182925.CrossRefPubMedPubMedCentral

26.

Bortolato B, Miskowiak KW, Köhler CA, Vieta E, Carvalho AF. Cognitive dysfunction in bipolar disorder and schizophrenia: a systematic review of meta-analyses. Neuropsychiatr Dis Treat. 2015;11:3111–25. https://doi.org/10.2147/NDT.S76700 eCollection 2015.CrossRefPubMedPubMedCentral

27.

Bora E, Pantelis C. Social cognition in schizophrenia in comparison to bipoLar disorder: a meta-analysis. Schizophr Res. 2016;175(1-3):72–8. https://doi.org/10.1016/j.schres.2016.04.018.CrossRefPubMed

28.

Green MF, Horan WP, Lee J. Nonsocial and social cognition in schizophrenia: current evidence and future directions. World Psychiatry. 2019;18(2):146–61. https://doi.org/10.1002/wps.20624 PMID: 31059632; PMCID: PMC6502429.CrossRefPubMedPubMedCentral

29.

Stirling J, White C, Lewis S, Hopkins R, Tantam D, Huddy A, et al. Neurocognitive function and outcome in first-episode schizophrenia: a 10-year follow-up of an epidemiological cohort. Schizophr Res. 2003;65(2–3):75–86. https://doi.org/10.1016/s0920-9964(03)00014-8 PMID: 14630300.CrossRefPubMed

30.

Varese F, Smeets F, Drukker M, et al. Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophr Bull. 2012;38(4):661–71. https://doi.org/10.1093/schbul/sbs050 Epub 2012 Mar 29. PMID: 22461484; PMCID: PMC3406538.CrossRefPubMedPubMedCentral

31.

Bonoldi I, Simeone E, Rocchetti M, Codjoe L, Rossi G, Gambi F, et al. Prevalence of self-reported childhood abuse in psychosis: a meta-analysis of retrospective studies. Psychiatry Res. 2013;210(1):8–15. https://doi.org/10.1016/j.psychres.2013.05.003 Epub 2013 Jun 20. PMID: 23790604.CrossRefPubMed

32.

Trauelsen AM, Bendall S, Jansen JE, Nielsen HGL, Pedersen MB, Trier CH, et al. Childhood adversity specificity and dose-response effect in non-affective first-episode psychosis. Schizophr Res. 2015;165(1):52–9. https://doi.org/10.1016/j.schres.2015.03.014 Epub 2015 Apr 11. PMID: 25868932.CrossRefPubMed

33.

Salokangas RKR, Schultze-Lutter F, Schmidt SJ, Pesonen H, Luutonen S, Patterson P, et al. Childhood physical abuse and emotional neglect are specifically associated with adult mental disorders. J Ment Health. 2020;29(4):376–84. https://doi.org/10.1080/09638237.2018.1521940 Epub 2019 Jan 24. PMID: 30675805.CrossRefPubMed

34.

Yung AR, Phillips LJ, McGorry PD, et al. Prediction of psychosis. A step towards indicated prevention of schizophrenia. Br J Psychiatry Suppl. 1998;172(33):14–20. https://doi.org/10.1192/S0007125000297602 PMID: 9764121.CrossRefPubMed

35.

Klosterkötter J, Hellmich M, Steinmeyer EM, Schultze-Lutter F. Diagnosing schizophrenia in the initial prodromal phase. Arch Gen Psychiatry. 2001;58(2):158–64. https://doi.org/10.1001/archpsyc.58.2.158 PMID: 11177117.CrossRefPubMed

36.

Miller TJ, McGlashan TH, Rosen JL, et al. Prospective diagnosis of the initial prodrome for schizophrenia based on the structured interview for prodromal syndromes: preliminary evidence of interrater reliability and predictive validity. Am J Psychiatry. 2002;159(5):863–5. https://doi.org/10.1176/appi.ajp.159.5.863 PMID: 11986145.CrossRefPubMed

37.

Fusar-Poli P, Bonoldi I, Yung AR, Borgwardt S, Kempton MJ, Valmaggia L, et al. Predicting psychosis: meta-analysis of transition outcomes in individuals at high clinical risk. Arch Gen Psychiatry. 2012;69(3):220–9. https://doi.org/10.1001/archgenpsychiatry.2011.1472 PMID: 22393215.CrossRefPubMed

38.

Fusar-Poli P, Cappucciati M, Borgwardt S, Woods SW, Addington J, Nelson B, et al. Heterogeneity of psychosis risk within individuals at clinical high risk: a Meta-analytical stratification. JAMA Psychiatry. 2016;73(2):113–20. https://doi.org/10.1001/jamapsychiatry.2015.2324.CrossRefPubMed

39.

Schmidt SJ, Schultze-Lutter F, Schimmelmann BG, Maric NP, Salokangas RKR, Riecher-Rössler A, et al. EPA guidance on the early intervention in clinical high risk states of psychoses. Eur Psychiatry. 2015;30(3):388–404. https://doi.org/10.1016/j.eurpsy.2015.01.013 Epub 2015 Mar 3.CrossRefPubMed

40.

Fusar-Poli P, Salazar de Pablo G, Correll CU, et al. Prevention of Psychosis: Advances in Detection, Prognosis, and Intervention. JAMA Psychiatry. 77(7):755–65. https://doi.org/10.1001/jamapsychiatry.2019.4779.

41.

Yung AR, Phillips LJ, Yuen HP, Francey SM, McFarlane CA, Hallgren M, et al. Psychosis prediction: 12-month follow up of a high-risk (“prodromal”) group. Schizophr Res. 2003;60(1):21–32. https://doi.org/10.1016/s0920-9964(02)00167-6 PMID: 12505135.CrossRefPubMed

42.

Cannon TD, Cadenhead K, Cornblatt B, Woods SW, Addington J, Walker E, et al. Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Arch Gen Psychiatry. 2008;65(1):28–37. https://doi.org/10.1001/archgenpsychiatry.2007.3.CrossRefPubMedPubMedCentral

43.

Ruhrmann S, Schultze-Lutter F, Salokangas RK, et al. Prediction of psychosis in adolescents and young adults at high risk: results from the prospective European prediction of psychosis study. Arch Gen Psychiatry. 2010;67(3):241–51. https://doi.org/10.1001/archgenpsychiatry.2009.206 PMID: 20194824.CrossRefPubMed

44.

Dragt S, Nieman DH, Schultze-Lutter F, van der Meer F, Becker H, de Haan L, et al. Cannabis use and age at onset of symptoms in subjects at clinical high risk for psychosis. Acta Psychiatr Scand. 2012;125(1):45–53. https://doi.org/10.1111/j.1600-0447.2011.01763.x Epub 2011 Aug 29. PMID: 21883099.CrossRefPubMed

45.

Fusar-Poli P, Nelson B, Valmaggia L, Yung AR, McGuire PK. Comorbid depressive and anxiety disorders in 509 individuals with an at-risk mental state: impact on psychopathology and transition to psychosis. Schizophr Bull. 2014;40(1):120–31. https://doi.org/10.1093/schbul/sbs136 Epub 2012 Nov 22. PMID: 23180756; PMCID: PMC3885287.CrossRefPubMed

46.

Salokangas RK, Dingemans P, Heinimaa M, EPOS group, et al. Prediction of psychosis in clinical high-risk patients by the schizotypal personality questionnaire. Results of the EPOS project. Eur Psychiatry. 2013a;28(8):469–75. https://doi.org/10.1016/j.eurpsy.2013.01.001 Epub 2013 Feb 8. PMID: 23394823.CrossRefPubMed

47.

Bolt LK, Amminger GP, Farhall J, McGorry PD, Nelson B, Markulev C, et al. Neurocognition as a predictor of transition to psychotic disorder and functional outcomes in ultra-high risk participants: findings from the NEURAPRO randomized clinical trial. Schizophr Res. 2019;206:67–74. https://doi.org/10.1016/j.schres.2018.12.013 Epub 2018 Dec 14.CrossRefPubMed

48.

Niendam TA, Bearden CE, Johnson JK, McKinley M, Loewy R, O'Brien M, et al. Neurocognitive performance and functional disability in the psychosis prodrome. Schizophr Res. 2006;84(1):100–11. https://doi.org/10.1016/j.schres.2006.02.005.CrossRefPubMed

49.

Addington J, Penn D, Woods SW, Addington D, Perkins DO. Social functioning in individuals at clinical high risk for psychosis. Schizophr Res. 2008;99(1–3):119–24. https://doi.org/10.1016/j.schres.2007.10.001 Epub 2007 Nov 19. PMID: 18023329; PMCID: PMC2292799.CrossRefPubMed

50.

Eslami A, Jahshan C, Cadenhead KS. Disorganized symptoms and executive functioning predict impaired social functioning in subjects at risk for psychosis. J Neuro-Oncol. 2011;23(4):457–60. https://doi.org/10.1176/appi.neuropsych.23.4.457.CrossRef

51.

Lin A, Wood SJ, Nelson B, Brewer WJ, Spiliotacopoulos D, Bruxner A, et al. Neurocognitive predictors of functional outcome two to 13 years after identification as ultra-high risk for psychosis. Schizophr Res. 2011;132(1):1–7. https://doi.org/10.1016/j.schres.2011.06.014 Epub 2011 Jul 16. PMID: 21763109.CrossRefPubMed

52.

Carrión RE, McLaughlin D, Goldberg TE, et al. Prediction of functional outcome in individuals at clinical high risk for psychosis. JAMA Psychiatry. 2013;70(11):1133–42. https://doi.org/10.1001/jamapsychiatry.2013.1909 PMID: 24006090; PMCID: PMC4469070.CrossRefPubMedPubMedCentral

53.

Glenthøj LB, Fagerlund B, Hjorthøj C, Jepsen JRM, Bak N, Kristensen TD, et al. Social cognition in patients at ultra-high risk for psychosis: what is the relation to social skills and functioning? Schizophr Res Cogn. 2016;5:21–7. https://doi.org/10.1016/j.scog.2016.06.004.CrossRefPubMedPubMedCentral

54.

Modinos G, Kempton MJ, Tognin S, EU-GEI High Risk Study Group, et al. Association of Adverse Outcomes With Emotion Processing and Its Neural Substrate in Individuals at Clinical High Risk for Psychosis. JAMA Psychiatry. 2020;77(2):190–200. https://doi.org/10.1001/jamapsychiatry.2019.3501 PMID: 31722018; PMCID: PMC6865249.CrossRefPubMed

55.

Cotter J, Drake RJ, Bucci S, Firth J, Edge D, Yung AR. What drives poor functioning in the at-risk mental state? A systematic review. Schizophr Res. 2014;159(2–3):267–77. https://doi.org/10.1016/j.schres.2014.09.012 Epub 2014 Sep 24.CrossRefPubMed

56.

Addington J, Stowkowy J, Cadenhead KS, et al. Early traumatic experiences in those at clinical high risk for psychosis. Early Interv Psychiatry. 2013;7(3):300–5. https://doi.org/10.1111/eip.12020 Epub 2013 Jan 24. PMID: 23343384; PMCID: PMC3754436.CrossRefPubMedPubMedCentral

57.

Kraan TC, Ising HK, Fokkema M, Velthorst E, van den Berg DPG, Kerkhoven M, et al. The effect of childhood adversity on 4-year outcome in individuals at ultra high risk for psychosis in the Dutch early detection intervention evaluation (EDIE-NL) trial. Psychiatry Res. 2017;247:55–62. https://doi.org/10.1016/j.psychres.2016.11.014 Epub 2016 Nov 11. PMID: 27863320.CrossRefPubMed

58.

Kraan T, van Dam DS, Velthorst E, et al. Childhood trauma and clinical outcome in patients at ultra-high risk of transition to psychosis. Schizophr Res. 2015;169(1–3):193–8. https://doi.org/10.1016/j.schres.2015.10.030 Epub 2015 Nov 14. PMID: 26585219.CrossRefPubMed

59.

RKR S, Patterson P, Hietala J, EPOS group, et al. Childhood adversity predicts persistence of suicidal thoughts differently in females and males at clinical high-risk patients of psychosis. Results of the EPOS project. Early Interv Psychiatry. 2019;13(4):935–42. https://doi.org/10.1111/eip.12714 Epub 2018 Jul 23. PMID: 30033690.CrossRef

60.

Salokangas RK, Heinimaa M, From T, EPOS group, et al. Short-term functional outcome and premorbid adjustment in clinical high-risk patients. Results of the EPOS project. Eur Psychiatry. 2014;29(6):371–80. https://doi.org/10.1016/j.eurpsy.2013.10.003 Epub 2013 Dec 7. PMID: 24315804.CrossRefPubMed

61.

Koutsouleris N, Kambeitz-Ilankovic L, Ruhrmann S, PRONIA Consortium, et al. Prediction Models of Functional Outcomes for Individuals in the Clinical High-Risk State for Psychosis or With Recent-Onset Depression: A Multimodal, Multisite Machine Learning Analysis. JAMA Psychiatry. 2018;75(11):1156–72. https://doi.org/10.1001/jamapsychiatry.2018.2165 Erratum in: JAMA Psychiatry. 2019 May 1;76(5):550. PMID: 30267047; PMCID: PMC6248111.CrossRefPubMedPubMedCentral

62.

First MB, Spitzer RL, Gibbon M, Williams JBW. Structured clinical interview for DSM-IV-TR Axis I disorders, research version, patient edition. New York: Biometrics Research, New York State Psychiatric Institute; 2002. (SCID-I/P)

63.

McGlashan TH, Miller TJ, Woods SW. Structured interview for prodromal syndromes. Version 3.0 Connecticut. New Haven: Yale School of Medicine, PRIME Research Clinic; 2001.

64.

McGlashan T, Walsh B, Woods S. The psychosis-risk syndrome: handbook for diagnosis and follow-up. Oxford: Oxford University Press; 2010.

65.

Cannon-Spoor HE, Potkin SG, Wyatt RJ. Measurement of premorbid adjustment in chronic schizophrenia. Schizophr Bull. 1982;8(3):470–84. https://doi.org/10.1093/schbul/8.3.470.CrossRefPubMed

66.

Patterson P, Skeate A, Schultze-Lutter F, Graf von Reventlow H, Wieneke A, Ruhrmann S, et al. The trauma and distress scale. Birmingham: University of Birmingham; 2002.

67.

Salokangas RKR, Schultze-Lutter F, Patterson P, von Reventlow HG, Heinimaa M, From T, et al. Psychometric properties of the Trauma and Distress Scale, TADS,in an adult community sample in Finland. Eur J Psychotraumatol. 2016;7(1):30062. https://doi.org/10.3402/ejpt.v7.30062.CrossRefPubMed

68.

Blumenthal JA, Burg MM, Barefoot J, Williams RB, Haney T, Zimet G. Social support, type a behavior, and coronary artery disease. Psychosom Med. 1987;49(4):331–40. https://doi.org/10.1097/00006842-198707000-00002 PMID: 3615762.CrossRefPubMed

69.

Wechsler D. Wechsler adult intelligence scale – III, Cleveland. Ohio: The psychological corporation; 2005. Finnish translation. Helsinki: Psykologien Kustannus Oy

70.

Blair JR, Spreen O. Predicting premorbid IQ: a revision of the National Adult Reading Test. Clin Neuropsychol. 1989;3(2):129–36. https://doi.org/10.1080/13854048908403285.CrossRef

71.

Spreen O, Strauss E. A compendium of neuropsychological tests. New York: Oxford University Press; 1998.

72.

Reitan RM. TMT, trail making test a & B; 1992.

73.

Wechsler D. Wechsler memory scale (3rd ed.) the psychological corporation, Harcourt brace Jovanovich, New York. Finnish translation. Psykologien Kustannus Oy: Helsinki; 2008.

74.

Brandt J, Benedict RHB. Hopkins verbal learning test – revised. Administration manual. Psychological Assessment Resources: Lutz FL; 2001.

75.

Benedict RHB. Brief visuospatial memory test - revised: professional manual. Psychological Assessment Resources Inc: Lutz, FL; 1997.

76.

White T, Stern RA. Neuropsychological assessment battery (NAB): demographically corrected norms manual. Psychological Assessment Resources Inc: Lutz, FL; 2003.

77.

Exner JE. The Rorschach: a comprehensive system. Vol. 1, 4th edition, basic foundations basic foundations and principles of interpretation. New York: Wiley; 2003.

78.

Mihura JL, Meyer GJ, Dumitrascu N, Bombel G. The validity of individual Rorschach variables: systematic reviews and meta-analyses of the comprehensive system. Psychol Bull. 2013;139(3):548–605. https://doi.org/10.1037/a0029406 Epub 2012 Aug 27. PMID: 22925137.CrossRefPubMed

79.

Heaton RK, Chelune GJ, Talley JL, Kay GG, Curtiss G. Wisconsin card sorting test manual: revised and expanded. Psychological Assessment Resources: Odessa, FL; 1993.

80.

Mayer JD, Salovey P, Caruso D. MSCEIT technical manual. Toronto: Multi-Health Systems; 2002.

81.

Cassidy CM, Norman R, Manchanda R, Schmitz N, Malla A. Testing definitions of symptom remission in first-episode psychosis for prediction of functional outcome at 2 years. Schizophr Bull. 2010;36(5):1001–8. https://doi.org/10.1093/schbul/sbp007 Epub 2009 Mar 25. PMID: 19321629; PMCID: PMC2930352.CrossRefPubMed

82.

Lally J, Ajnakina O, Stubbs B, Cullinane M, Murphy KC, Gaughran F, et al. Remission and recovery from first-episode psychosis in adults: systematic review and meta-analysis of long-term outcome studies. Br J Psychiatry. 2017;211(6):350–8. https://doi.org/10.1192/bjp.bp.117.201475 Epub 2017 Oct 5. PMID: 28982659.CrossRefPubMed

83.

Zigler E, Phillips L. Social competence and outcome in psychiatric disorders. J Abnorm Soc Psychol. 1961;63(2):264–71. https://doi.org/10.1037/h0046232.CrossRef

84.

Zigler E, Phillips L. Social competence and the process-reactive distinction in psychopathology. J Abnorm Soc Psychol. 1962;65(4):215–22. https://doi.org/10.1037/h0040765 PMID: 14003638.CrossRefPubMed

85.

Salokangas RK, Honkonen T, Stengård E, Koivisto AM. To be or not to be married--that is the question of quality of life in men with schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2001;36(8):381–90. 11766968. https://doi.org/10.1007/s001270170028.CrossRefPubMed

86.

Salokangas RK, Nieman DH, Heinimaa M, EPOS group, et al. Psychosocial outcome in patients at clinical high risk of psychosis: a prospective follow-up. Soc Psychiatry Psychiatr Epidemiol. 2013b;48(2):303–11. https://doi.org/10.1007/s00127-012-0545-2 Epub 2012 Jul 15. PMID: 22797132.CrossRefPubMed

87.

Ventura J, Hellemann GS, Thames AD, Koellner V, Nuechterlein KH. Symptoms as mediators of the relationship between neurocognition and functional outcome in schizophrenia: a meta-analysis. Schizophr Res. 2009;113(2–3):189–99. https://doi.org/10.1016/j.schres.2009.03.035 Epub 2009 Jul 22. PMID: 19628375; PMCID: PMC2825750.CrossRefPubMedPubMedCentral

88.

Webb JR, Addington J, Perkins DO, et al. Specificity of Incident Diagnostic Outcomes in Patients at Clinical High Risk for Psychosis. Schizophr Bull. 2015;41(5):1066–75. https://doi.org/10.1093/schbul/sbv091 Erratum in: Schizophr Bull. 2018;44(4):933–935. PMID: 26272875; PMCID: PMC4535651.CrossRefPubMedPubMedCentral

89.

Fusar-Poli P, Rutigliano G, Stahl D, Davies C, de Micheli A, Ramella-Cravaro V, et al. Long-term validity of the at risk mental state (ARMS) for predicting psychotic and non-psychotic mental disorders. Eur Psychiatry. 2017;42:49–54. https://doi.org/10.1016/j.eurpsy.2016.11.010 Epub 2016 Dec 6. PMID: 28212505.CrossRefPubMed

90.

Woods SW, Powers AR 3rd, Taylor JH, et al. Lack of Diagnostic Pluripotentiality in Patients at Clinical High Risk for Psychosis: Specificity of Comorbidity Persistence and Search for Pluripotential Subgroups. Schizophr Bull. 2018;44(2):254–63. https://doi.org/10.1093/schbul/sbx138 PMID: 29036402; PMCID: PMC5814797.CrossRefPubMed

91.

Kraan TC, Velthorst E, Themmen M, EU-GEI High Risk Study, et al. Child Maltreatment and Clinical Outcome in Individuals at Ultra-High Risk for Psychosis in the EU-GEI High Risk Study. Schizophr Bull. 2018;44(3):584–92. https://doi.org/10.1093/schbul/sbw162 PMID: 28666366; PMCID: PMC5890491.CrossRefPubMed

92.

Salokangas RK, Ruhrmann S, von Reventlow HG, EPOS group, et al. Axis I diagnoses and transition to psychosis in clinical high-risk patients EPOS project: prospective follow-up of 245 clinical high-risk outpatients in four countries. Schizophr Res. 2012;138(2–3):192–7. https://doi.org/10.1016/j.schres.2012.03.008 Epub 2012 Mar 31. PMID: 22464922.CrossRefPubMed

93.

Falkenberg I, Valmaggia L, Byrnes M, Frascarelli M, Jones C, Rocchetti M, et al. Why are help-seeking subjects at ultra-high risk for psychosis help-seeking? Psychiatry Res. 2015;228(3):808–15. https://doi.org/10.1016/j.psychres.2015.05.018 Epub 2015 May 30. PMID: 26071897.CrossRefPubMed

94.

Rutigliano G, Valmaggia L, Landi P, Frascarelli M, Cappucciati M, Sear V, et al. Persistence or recurrence of non-psychotic comorbid mental disorders associated with 6-year poor functional outcomes in patients at ultra high risk for psychosis. J Affect Disord. 2016;203:101–10. https://doi.org/10.1016/j.jad.2016.05.053 Epub 2016 May 31. PMID: 27285723.CrossRefPubMed

95.

Kahn RS, Sommer IE, Murray RM, Meyer-Lindenberg A, Weinberger DR, Cannon TD, et al. Schizophrenia. Nat Rev Dis Primers. 2015;1(1):15067. https://doi.org/10.1038/nrdp.2015.67 PMID: 27189524.CrossRefPubMed

96.

Rosenheck R, Mueser KT, Sint K, Lin H, Lynde DW, Glynn SM, et al. Supported employment and education in comprehensive, integrated care for first episode psychosis: effects on work, school, and disability income. Schizophr Res. 2017;182:120–8. https://doi.org/10.1016/j.schres.2016.09.024 Epub 2016 Sep 23. PMID: 27667369.CrossRefPubMed

97.

Modini M, Tan L, Brinchmann B, Wang MJ, Killackey E, Glozier N, et al. Supported employment for people with severe mental illness: systematic review and meta-analysis of the international evidence. Br J Psychiatry. 2016;209(1):14–22. https://doi.org/10.1192/bjp.bp.115.165092 Epub 2016 Apr 21. PMID: 27103678.CrossRefPubMed

98.

Bell MD, Bryson GJ, Greig TC, Fiszdon JM, Wexler BE. Neurocognitive enhancement therapy with work therapy: productivity outcomes at 6- and 12-month follow-ups. J Rehabil Res Dev. 2005;42(6):829–38. https://doi.org/10.1682/jrrd.2005.03.0061 PMID: 16680620.CrossRefPubMed

99.

Bell MD, Choi KH, Dyer C, Wexler BE. Benefits of cognitive remediation and supported employment for schizophrenia patients with poor community functioning. Psychiatr Serv. 2014;65(4):469–75. https://doi.org/10.1176/appi.ps.201200505 PMID: 24382594.CrossRefPubMed

100.

Chan JY, Hirai HW, Tsoi KK. Can computer-assisted cognitive remediation improve employment and productivity outcomes of patients with severe mental illness? A meta-analysis of prospective controlled trials. J Psychiatr Res. 2015;68:293–300. https://doi.org/10.1016/j.jpsychires.2015.05.010 Epub 2015 May 21. PMID: 26028551.CrossRefPubMed

Title: Short-term functional outcome in psychotic patients: results of the Turku early psychosis study (TEPS)
Authors: Raimo K. R. Salokangas
Tiina From
Tuula Ilonen
Sinikka Luutonen
Markus Heinimaa
Reetta-Liina Armio
Heikki Laurikainen
Maija Walta
Janina Paju
Anna Toivonen
Päivi Jalo
Lauri Tuominen
Jarmo Hietala
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-021-03516-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Short-term functional outcome in psychotic patients: results of the Turku early psychosis study (TEPS)

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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