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

Natalia Tiles-Sar*, Tesfa Dejenie Habtewold, Edith J. Liemburg, Lisette Van Der Meer, Richard Bruggeman, Behrooz Z. Alizadeh, Therese Van Amelsvoort, Agna A. Bartels-Velthuis, Lieuwe De Haan, Frederike Schirmbeck, Claudia J.P. Simons, Jim Van Os

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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.
Original languageEnglish
Pages (from-to)1447-1459
Number of pages13
JournalSchizophrenia Bulletin
Volume49
Issue number6
DOIs
Publication statusPublished - 29 Nov 2023

Keywords

  • association
  • follow-up
  • mixed-effect model/trajectories
  • schizophrenia

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