The Role of Premorbid IQ and Age of Onset as Useful Predictors of Clinical, Functional Outcomes, and Recovery of Individuals with a First Episode of Psychosis

Background: premorbid IQ (pIQ) and age of onset are predictors of clinical severity and long-term functioning after a first episode of psychosis. However, the additive influence of these variables on clinical, functional, and recovery rates outcomes is largely unknown. Methods: we characterized 255...

Descripción completa

Detalles Bibliográficos
Autores: Molina-García, Mariola, Fraguas, David|||0000-0002-7931-2933, del Rey-Mejías, Ángel|||0000-0003-1690-3215, Mezquida, Gisela|||0000-0002-6080-2203, Sánchez-Torres, Ana Maria|||0000-0002-9505-2406, Amoretti, Silvia|||0000-0001-6017-2734, Lobo, Antonio|||0000-0002-9098-655X, González-Pinto, Ana|||0000-0002-2568-5179, Andreu-Bernabeu, Álvaro, Corripio, Iluminada|||0000-0003-2562-711X, Vieta, Eduard|||0000-0002-0548-0053, Baeza, Inmaculada|||0000-0003-2611-5781, Mané, Anna|||0000-0003-2127-349X, Cuesta, Manuel J.|||0000-0003-0250-5718, de la Serna, Elena|||0000-0002-7869-9881, Payá, Beatriz, Zorrilla, Iñaki|||0000-0001-6444-8208, Arango, Celso|||0000-0003-3382-4754, Bernardo, Miquel|||0000-0001-8748-6717, Rapado-Castro, Marta|||0000-0001-8484-6051, Parellada, Mara|||0000-0001-7977-3601
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:256433
Acceso en línea:https://ddd.uab.cat/record/256433
https://dx.doi.org/urn:doi:10.3390/jcm10112474
Access Level:acceso abierto
Palabra clave:Psychosis
First-episode
Premorbid intelligence
Age at onset
Functional outcome
Remission
Recovery
Heterogeneity
Subgroup
Descripción
Sumario:Background: premorbid IQ (pIQ) and age of onset are predictors of clinical severity and long-term functioning after a first episode of psychosis. However, the additive influence of these variables on clinical, functional, and recovery rates outcomes is largely unknown. Methods: we characterized 255 individuals who have experienced a first episode of psychosis in four a priori defined subgroups based on pIQ (low pIQ < 85; average pIQ ≥ 85) and age of onset (early onset < 18 years; adult onset ≥ 18 years). We conducted clinical and functional assessments at baseline and at two-year follow-up. We calculated symptom remission and recovery rates using the Positive and Negative Symptoms of Schizophrenia Schedule (PANSS) and the Global Assessment Functioning (GAF or Children-GAF). We examined clinical and functional changes with pair-wise comparisons and two-way mixed ANOVA. We built hierarchical lineal and logistic regression models to estimate the predictive value of the independent variables over functioning or recovery rates. Results: early-onset patients had more severe positive symptoms and poorer functioning than adult-onset patients. At two-year follow-up, only early-onset with low pIQ and adult-onset with average pIQ subgroups differed consistently, with the former having more negative symptoms (d = 0.59), poorer functioning (d = 0.82), lower remission (61% vs. 81.1%), and clinical recovery (34.1% vs. 62.2%). Conclusions: early-onset individuals with low pIQ may present persistent negative symptoms, lower functioning, and less recovery likelihood at two-year follow-up. Intensive cognitive and functional programs for these individuals merit testing to improve long-term recovery rates in this subgroup.

Similares en LA Referencia