Childhood maltreatment and transition to psychotic disorder independently predict long-term functioning in young people at ultra-high risk for psychosis

A.R. Yung, J. Cotter, S.J. Wood, P. Mcgorry, A.D. Thompson, B. Nelson, Ashleigh Lin

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

© 2015 Cambridge University Press. Individuals identified as at ultra-high risk (UHR) for psychosis are at risk of poor functional outcome regardless of development of psychotic disorder. Studies examining longitudinal predictors of poor functioning have tended to be small and report only medium-term follow-up data. We sought to examine clinical predictors of functional outcome in a long-term longitudinal study. Method. Participants were 268 (152 females, 116 males) individuals identified as UHR 2-14 years previously. A range of clinical and sociodemographic variables were assessed at baseline. Functioning at follow-up was assessed using the Social and Occupational Functioning Assessment Scale (SOFAS). Results. Baseline negative symptoms, impaired emotional functioning, disorders of thought content, low functioning, past substance use disorder and history of childhood maltreatment predicted poor functioning at follow-up in univariate analyses. Only childhood maltreatment remained significant in the multivariate analysis (p <0.001). Transition to psychosis was also significantly associated with poor functioning at long-term follow-up [mean SOFAS score 59.12 (s.d. = 18.54) in the transitioned group compared to 70.89 (s.d. = 14.00) in the non-transitioned group, p <0.001]. Childhood maltreatment was a significant predictor of poor functioning in both the transitioned and non-transitioned groups. Conclusions. Childhood maltreatment and transition to psychotic disorder independently predicted poor long-term functioning. This suggests that it is important to assess history of childhood maltreatment in clinical management of UHR individuals. The finding that transition to psychosis predicts poor long-term functioning strengthens the evidence that the UHR criteria detect a subgroup at risk for schizophrenia.
Original languageEnglish
Pages (from-to)3453-3465
JournalPsychological Medicine
Volume45
Issue number16
Early online date13 Jul 2015
DOIs
Publication statusPublished - Dec 2015

Fingerprint

Psychotic Disorders
Longitudinal Studies
Substance-Related Disorders
Schizophrenia
Multivariate Analysis

Cite this

Yung, A.R. ; Cotter, J. ; Wood, S.J. ; Mcgorry, P. ; Thompson, A.D. ; Nelson, B. ; Lin, Ashleigh. / Childhood maltreatment and transition to psychotic disorder independently predict long-term functioning in young people at ultra-high risk for psychosis. In: Psychological Medicine. 2015 ; Vol. 45, No. 16. pp. 3453-3465.
@article{58238fbbb6df4b228a1f818baa89e5f0,
title = "Childhood maltreatment and transition to psychotic disorder independently predict long-term functioning in young people at ultra-high risk for psychosis",
abstract = "{\circledC} 2015 Cambridge University Press. Individuals identified as at ultra-high risk (UHR) for psychosis are at risk of poor functional outcome regardless of development of psychotic disorder. Studies examining longitudinal predictors of poor functioning have tended to be small and report only medium-term follow-up data. We sought to examine clinical predictors of functional outcome in a long-term longitudinal study. Method. Participants were 268 (152 females, 116 males) individuals identified as UHR 2-14 years previously. A range of clinical and sociodemographic variables were assessed at baseline. Functioning at follow-up was assessed using the Social and Occupational Functioning Assessment Scale (SOFAS). Results. Baseline negative symptoms, impaired emotional functioning, disorders of thought content, low functioning, past substance use disorder and history of childhood maltreatment predicted poor functioning at follow-up in univariate analyses. Only childhood maltreatment remained significant in the multivariate analysis (p <0.001). Transition to psychosis was also significantly associated with poor functioning at long-term follow-up [mean SOFAS score 59.12 (s.d. = 18.54) in the transitioned group compared to 70.89 (s.d. = 14.00) in the non-transitioned group, p <0.001]. Childhood maltreatment was a significant predictor of poor functioning in both the transitioned and non-transitioned groups. Conclusions. Childhood maltreatment and transition to psychotic disorder independently predicted poor long-term functioning. This suggests that it is important to assess history of childhood maltreatment in clinical management of UHR individuals. The finding that transition to psychosis predicts poor long-term functioning strengthens the evidence that the UHR criteria detect a subgroup at risk for schizophrenia.",
author = "A.R. Yung and J. Cotter and S.J. Wood and P. Mcgorry and A.D. Thompson and B. Nelson and Ashleigh Lin",
year = "2015",
month = "12",
doi = "10.1017/S003329171500135X",
language = "English",
volume = "45",
pages = "3453--3465",
journal = "Psychological Medicine.",
issn = "0033-2917",
publisher = "Cambridge University Press",
number = "16",

}

Childhood maltreatment and transition to psychotic disorder independently predict long-term functioning in young people at ultra-high risk for psychosis. / Yung, A.R.; Cotter, J.; Wood, S.J.; Mcgorry, P.; Thompson, A.D.; Nelson, B.; Lin, Ashleigh.

In: Psychological Medicine, Vol. 45, No. 16, 12.2015, p. 3453-3465.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Childhood maltreatment and transition to psychotic disorder independently predict long-term functioning in young people at ultra-high risk for psychosis

AU - Yung, A.R.

AU - Cotter, J.

AU - Wood, S.J.

AU - Mcgorry, P.

AU - Thompson, A.D.

AU - Nelson, B.

AU - Lin, Ashleigh

PY - 2015/12

Y1 - 2015/12

N2 - © 2015 Cambridge University Press. Individuals identified as at ultra-high risk (UHR) for psychosis are at risk of poor functional outcome regardless of development of psychotic disorder. Studies examining longitudinal predictors of poor functioning have tended to be small and report only medium-term follow-up data. We sought to examine clinical predictors of functional outcome in a long-term longitudinal study. Method. Participants were 268 (152 females, 116 males) individuals identified as UHR 2-14 years previously. A range of clinical and sociodemographic variables were assessed at baseline. Functioning at follow-up was assessed using the Social and Occupational Functioning Assessment Scale (SOFAS). Results. Baseline negative symptoms, impaired emotional functioning, disorders of thought content, low functioning, past substance use disorder and history of childhood maltreatment predicted poor functioning at follow-up in univariate analyses. Only childhood maltreatment remained significant in the multivariate analysis (p <0.001). Transition to psychosis was also significantly associated with poor functioning at long-term follow-up [mean SOFAS score 59.12 (s.d. = 18.54) in the transitioned group compared to 70.89 (s.d. = 14.00) in the non-transitioned group, p <0.001]. Childhood maltreatment was a significant predictor of poor functioning in both the transitioned and non-transitioned groups. Conclusions. Childhood maltreatment and transition to psychotic disorder independently predicted poor long-term functioning. This suggests that it is important to assess history of childhood maltreatment in clinical management of UHR individuals. The finding that transition to psychosis predicts poor long-term functioning strengthens the evidence that the UHR criteria detect a subgroup at risk for schizophrenia.

AB - © 2015 Cambridge University Press. Individuals identified as at ultra-high risk (UHR) for psychosis are at risk of poor functional outcome regardless of development of psychotic disorder. Studies examining longitudinal predictors of poor functioning have tended to be small and report only medium-term follow-up data. We sought to examine clinical predictors of functional outcome in a long-term longitudinal study. Method. Participants were 268 (152 females, 116 males) individuals identified as UHR 2-14 years previously. A range of clinical and sociodemographic variables were assessed at baseline. Functioning at follow-up was assessed using the Social and Occupational Functioning Assessment Scale (SOFAS). Results. Baseline negative symptoms, impaired emotional functioning, disorders of thought content, low functioning, past substance use disorder and history of childhood maltreatment predicted poor functioning at follow-up in univariate analyses. Only childhood maltreatment remained significant in the multivariate analysis (p <0.001). Transition to psychosis was also significantly associated with poor functioning at long-term follow-up [mean SOFAS score 59.12 (s.d. = 18.54) in the transitioned group compared to 70.89 (s.d. = 14.00) in the non-transitioned group, p <0.001]. Childhood maltreatment was a significant predictor of poor functioning in both the transitioned and non-transitioned groups. Conclusions. Childhood maltreatment and transition to psychotic disorder independently predicted poor long-term functioning. This suggests that it is important to assess history of childhood maltreatment in clinical management of UHR individuals. The finding that transition to psychosis predicts poor long-term functioning strengthens the evidence that the UHR criteria detect a subgroup at risk for schizophrenia.

U2 - 10.1017/S003329171500135X

DO - 10.1017/S003329171500135X

M3 - Article

VL - 45

SP - 3453

EP - 3465

JO - Psychological Medicine.

JF - Psychological Medicine.

SN - 0033-2917

IS - 16

ER -