Martina Brandizzi1, Masillo Alice2, Liliana Todini3, Juliana Fortes Lindau3, Nella Lo Cascio4, Riccardo Saba5, Elena Monducci3, Ludovica Telesforo5, Paolo Girardi6, Paolo Fiori Nastro3, Christoph U. Correll7,8; 1Department of Mental Health, Asl Rome 1, Rome Italy, 2Department of Mental Health, Asl Rome 2, Rome Italy, 3Faculty of Medicine and Odontology, Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy, 4MD, PhD, Psychiatrist, 5MD, Psychiatrist, 6Neurosciences, Mental Health and Sensory Functions (NESMOS) Department, Faculty of Medicine and Psychology, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy, 7Recognition and Prevention (RAP) Program, Department of Psychiatry, The Zucker Hillside Hospital, New York, US, 8Charité - Universitätsmedizin Berlin Augustenburger Platz 1, Berlin, Germany
Objective: Psychosocial functioning impairment is a typical feature of early stages of many mental disorders. A critical research goal is to identify modifiable risk factors leading to poor social and role functioning in young people with subtle psychotic symptoms. The aim of the present study was to investigate the longitudinal psychosocial functional outcome of a sample of young individuals with attenuated psychotic symptoms and the predictive role of baseline psychopathological characteristics. Methods: The sample consisted of 95 young subjects (mean age=16.43) involved in the follow-up assessment of the early detection project “Liberiamo il Futuro” (LIF). Baseline data on socio-demographic and psychopathological characteristics, psychosis risk status, and functional levels were collected. A binary logistic regression model was performed to predict poor social and role functioning at follow-up as defined by a score <7 in the Global Functioning: Role scale and Global Functioning: Social scale. Results: Psychosocial functioning at follow-up was moderately impaired: 44% of the sample (n=37) had poor role and social functional outcome. Decreased expression of emotion, poorer premorbid social and role functioning, and less change in overall psychopathology symptom severity significantly predicted poor role functioning (R2=0.531; Model Chi square: 39.37, P≤0.0001). Decreased expression of emotion, poorer premorbid social functioning, and presence of stressful life events between baseline and follow-up predicted poorer social functioning (R2=0.573; Model Chi square: 45.85, P≤0.0001). Conclusion: These findings suggest that taking into account the severity of negative symptoms, in particular disruption of affectivity levels, the premorbid functioning and the severity of the overall psychopathology has the potential to identify individuals with low psychosocial functional outcome independent of attenuated positive symptoms and transition to psychosis. Psychotherapeutic interventions especially targeting negative symptoms, poor role an social functioning and effects of stressful life events should be developed and provided to individuals with attenuated psychotic symptoms.
