Understanding Lifelong Factors and Prediction Models of Social Functioning After Psychosis Onset Using the Large-Scale GROUP Cohort Study

Author:

Tiles-Sar Natalia12ORCID,Habtewold Tesfa Dejenie1,Liemburg Edith J2,van der Meer Lisette34,Bruggeman Richard2,Alizadeh Behrooz Z1,Bruggeman Richard56,Alizadeh Behrooz Z7,van Amelsvoort Therese8,Bartels-Velthuis Agna A5,de Haan Lieuwe910,Schirmbeck Frederike910,Simons Claudia J P811,van Os Jim1213,

Affiliation:

1. Department of Epidemiology, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands

2. Department of Psychiatry, Rob Giel Research Center, University Medical Center Groningen, University Center for Psychiatry, University of Groningen , Groningen , The Netherlands

3. Department of Clinical and Developmental Neuropsychology, Universityof Groningen , Groningen , The Netherlands

4. Department of Rehabilitation, Lentis Psychiatric Institute , Zuidlaren , The Netherlands

5. Department of Psychiatry, University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center , Groningen , The Netherlands

6. Department of Clinical and Developmental Neuropsychology, University of Groningen , Groningen , The Netherlands

7. Department of Epidemiology, University Medical Center Groningen , Groningen , The Netherlands

8. Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center Maastricht , The Netherlands

9. Department of Psychiatry, Amsterdam UMC, University of Amsterdam , Amsterdam , The Netherlands

10. Research Department, Arkin Institute for Mental Health , Amsterdam , The Netherlands

11. GGzE Institute for Mental Health Care , Eindhoven , The Netherlands

12. Department of Psychiatry, University Medical Center Utrecht Brain Centre Rudolf Magnus, Utrecht University , Utrecht , The Netherlands

13. Department of Psychosis Studies, King’s College London, King’s Health Partners, Institute of Psychiatry , London , UK

Abstract

Abstract Background and hypothesis Current rates of poor social functioning (SF) in people with psychosis history reach 80% worldwide. We aimed to identify a core set of lifelong predictors and build prediction models of SF after psychosis onset. Study design We utilized data of 1119 patients from the Genetic Risk and Outcome in Psychosis (GROUP) longitudinal Dutch cohort. First, we applied group-based trajectory modeling to identify premorbid adjustment trajectories. We further investigated the association between the premorbid adjustment trajectories, six-year-long cognitive deficits, positive, and negative symptoms trajectories, and SF at 3-year and 6-year follow-ups. Next, we checked associations between demographics, clinical, and environmental factors measured at the baseline and SF at follow-up. Finally, we built and internally validated 2 predictive models of SF. Study results We found all trajectories were significantly associated with SF (P < .01), explaining up to 16% of SF variation (R2 0.15 for 3- and 0.16 for 6-year follow-up). Demographics (sex, ethnicity, age, education), clinical parameters (genetic predisposition, illness duration, psychotic episodes, cannabis use), and environment (childhood trauma, number of moves, marriage, employment, urbanicity, unmet needs of social support) were also significantly associated with SF. After validation, final prediction models explained a variance up to 27% (95% CI: 0.23, 0.30) at 3-year and 26% (95% CI: 0.22, 0.31) at 6-year follow-up. Conclusions We found a core set of lifelong predictors of SF. Yet, the performance of our prediction models was moderate.

Funder

GGZ Drenthe

GGZ Friesland

GGZ inGeest

Health Research

Publisher

Oxford University Press (OUP)

Subject

Psychiatry and Mental health

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