TY - JOUR
T1 - Association between exposome score for schizophrenia and functioning in first-episode psychosis
T2 - results from the Athens first-episode psychosis research study
AU - Erzin, Gamze
AU - Pries, Lotta-Katrin
AU - Dimitrakopoulos, Stefanos
AU - Ralli, Irene
AU - Xenaki, Lida-Alkisti
AU - Soldatos, Rigas-Filippos
AU - Vlachos, Ilias
AU - Selakovic, Mirjana
AU - Foteli, Stefania
AU - Kosteletos, Ioannis
AU - Nianiakas, Nikos
AU - Mantonakis, Leonidas
AU - Rizos, Emmanouil
AU - Kollias, Konstantinos
AU - Van Os, Jim
AU - Guloksuz, Sinan
AU - Stefanis, Nikos
N1 - Funding Information:
Financial Support: Dr Erzin is supported by the Scientific and Technological Research Council of Turkey, 2219 International Postdoctoral Research Fellowship Program. Dr Pries is supported by the Kootstra Talent Fellowship of Maastricht University. Dr Guloksuz and van Os are supported by the Ophelia research project, ZonMw grant number: 636340001.
Publisher Copyright:
Copyright © The Author(s), 2021. Published by Cambridge University Press.
PY - 2023/4
Y1 - 2023/4
N2 - 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.
AB - 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.
KW - ASSESSMENT SCALE
KW - CANNABIS USE
KW - Cannabis use
KW - FOLLOW-UP
KW - GLOBAL ASSESSMENT
KW - HIGH-RISK
KW - IMPACT
KW - ONSET
KW - RELIABILITY
KW - REMISSION
KW - SYMPTOMS
KW - childhood trauma
KW - environment
KW - functioning
KW - outcome
KW - psychosis
U2 - 10.1017/S0033291721004542
DO - 10.1017/S0033291721004542
M3 - Article
C2 - 34789350
SN - 0033-2917
VL - 53
SP - 2609
EP - 2618
JO - Psychological Medicine
JF - Psychological Medicine
IS - 6
ER -