Association between exposome score for schizophrenia and functioning in first-episode psychosis: results from the Athens first-episode psychosis research study

被引：17

作者：

Erzin, Gamze ^{[1
,2
]}

Pries, Lotta-Katrin ^{[2
]}

Dimitrakopoulos, Stefanos ^{[3
,4
]}

Ralli, Irene ^{[3
]}

Xenaki, Lida-Alkisti ^{[3
]}

Soldatos, Rigas-Filippos ^{[3
]}

Vlachos, Ilias ^{[3
]}

Selakovic, Mirjana ^{[3
]}

Foteli, Stefania ^{[3
]}

Kosteletos, Ioannis ^{[3
]}

Nianiakas, Nikos ^{[3
]}

Mantonakis, Leonidas ^{[3
]}

Rizos, Emmanouil ^{[5
]}

Kollias, Konstantinos ^{[3
]}

Van Os, Jim ^{[2
,6
,7
]}

Guloksuz, Sinan ^{[2
,8
]}

Stefanis, Nikos ^{[3
]}

机构：

[1] Univ Hlth Sci, Ankara Diskapi Training & Res Hosp, Dept Psychiat, Ankara, Turkey

[2] Maastricht Univ, Sch Mental Hlth & Neurosci, Med Ctr, Dept Psychiat & Neuropsychol, Maastricht, Netherlands

[3] Natl & Kapodistrian Univ Athens, Eginit Hosp, Med Sch, Dept Psychiat 1, Athens, Greece

[4] 414 Mil Hosp Athens, Psychiat Clin, Penteli, Greece

[5] Natl & Kapodistrian Univ Athens, ATTIKON Univ Hosp, Med Sch, Dept Psychiat 2, Athens, Greece

[6] Univ Utrecht, Univ Med Ctr Utrecht, UMC Utrecht Brain Ctr, Dept Psychiat, Utrecht, Netherlands

[7] Kings Coll London, Inst Psychiat, Dept Psychosis Studies, London, England

[8] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT 06520 USA

来源：

PSYCHOLOGICAL MEDICINE | 2023年 / 53卷 / 06期

关键词：

Cannabis use; childhood trauma; environment; functioning; outcome; psychosis; CANNABIS USE; GLOBAL ASSESSMENT; HIGH-RISK; ASSESSMENT SCALE; FOLLOW-UP; IMPACT; REMISSION; SYMPTOMS; ONSET; RELIABILITY;

D O I：

10.1017/S0033291721004542

中图分类号：

B849 [应用心理学];

学科分类号：

040203 ;

摘要：

Background Evidence suggests that environmental factors not only increase psychosis liability but also influence the prognosis and outcomes of psychotic disorders. We investigated temporal and cross-sectional associations of a weighted score of cumulative environmental liability for schizophrenia - the exposome score for schizophrenia (ES-SCZ) - with functioning in first-episode psychosis (FEP). Methods Data were derived from the baseline and 1-month assessments of the Athens FEP Research Study that enrolled 225 individuals with FEP. The Global Assessment of Functioning (GAF) and the Personal and Social Performance Scale (PSP) were used to measure social, occupational, and psychological functioning. The ES-SCZ was calculated based on the previously validated method. Results ES-SCZ was associated with the total scores of GAF and PSP at baseline and 1-month assessments. These findings remained significant when accounting for several associated alternative explanatory variables, including other environmental factors (obstetric complications, migration, ethnic minority), clinical characteristics (duration of untreated psychosis, symptom severity, previous antipsychotic use), and family history of psychosis, demonstrating that the association between ES-SCZ and functioning is over and above other risk factors and cannot be explained by symptom severity alone. Functioning improved from baseline to 1-month assessment, but no significant ES-SCZ-by-time interaction was found on functioning, indicating that functioning changes were not contingent on ES-SCZ. Conclusions Our findings suggest that rather than a predictor of functional improvement, ES-SCZ represents a stable severity indicator that captures poor functioning in early psychosis. Environmental risk loading for schizophrenia (ES-SCZ) can be beneficial for clinical characterization and incorporated into transdiagnostic staging models.

引用

页码：2609 / 2618

页数：10

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