TY - JOUR
T1 - Understanding Lifelong Factors and Prediction Models of Social Functioning After Psychosis Onset Using the Large-Scale GROUP Cohort Study
AU - Tiles-Sar, Natalia
AU - Habtewold, Tesfa Dejenie
AU - Liemburg, Edith J.
AU - Van Der Meer, Lisette
AU - Bruggeman, Richard
AU - Alizadeh, Behrooz Z.
AU - Van Amelsvoort, Therese
AU - Bartels-Velthuis, Agna A.
AU - De Haan, Lieuwe
AU - Schirmbeck, Frederike
AU - Simons, Claudia J.P.
AU - Van Os, Jim
N1 - Funding Information:
The infrastructure for the GROUP study is funded through the Geestkracht programme of the Dutch Health Research Council (Zon-Mw, grant number 10-000-1001), and matching funds from participating pharmaceutical companies (Lundbeck, AstraZeneca, Eli Lilly, Janssen Cilag) and universities and mental health care organizations (Amsterdam: Academic Psychiatric Centre of the Academic Medical Center and the mental health institutions: GGZ Ingeest, Arkin, Dijk en Duin, GGZ Rivierduinen, Erasmus Medical Centre, GGZ Noord Holland Noord. Groningen: University Medical Center Groningen and the mental health institutions: Lentis, GGZ Friesland, GGZ Drenthe, Dimence, Mediant, GGNet Warnsveld, Yulius Dordrecht and Parnassia psycho-medical center The Hague. Maastricht: Maastricht University Medical Centre and the mental health institutions: GGzE, GGZ Breburg, GGZ Oost-Brabant, Vincent van Gogh voor Geestelijke Gezondheid, Mondriaan, Virenze riagg, Zuyderland GGZ, MET ggz, Universitair Centrum Sint-Jozef Kortenberg, CAPRI University of Antwerp, PC Ziekeren Sint-Truiden, PZ Sancta Maria Sint-Truiden, GGZ Overpelt, OPZ Rekem. Utrecht: University Medical Center Utrecht and the mental health institutions Altrecht, GGZ Centraal and Delta).
Funding Information:
The authors are grateful to the patients, their families, and healthy subjects for their generosity of time and effort. Furthermore, the authors would like to thank all research personnel involved in the GROUP project. Natalia Tiles-Sar was supported by a master’s scholarship from the Graduate School for Medical Science, University of Groningen, Groningen, the Netherlands.
Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.
PY - 2023/11/1
Y1 - 2023/11/1
N2 - 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.
AB - 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.
KW - association
KW - follow-up
KW - mixed-effect model/trajectories
KW - schizophrenia
U2 - 10.1093/schbul/sbad046
DO - 10.1093/schbul/sbad046
M3 - Article
SN - 0586-7614
VL - 49
SP - 1447
EP - 1459
JO - Schizophrenia Bulletin
JF - Schizophrenia Bulletin
IS - 6
ER -