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A critical research goal is to identify modifiable risk factors leading to functional disabilities in young psychiatric patients. The authors developed a multidimensional trans-diagnostic predictive model of functional outcome in patients with the recent-onset of a psychiatric illness. Baseline clinical, psychosis-risk status, cognitive, neurological-soft-signs measures, and dopamine-related-gene polymorphisms (DRD1-rs4532, COMT-rs165599, and DRD4-rs1800955) were collected in 138 young non-psychotic outpatients. 116 individuals underwent follow-up (mean=2.2years, SD=0.9) examination. A binary logistic model was used to predict low-functioning status at follow-up as defined by a score lower than 65 in the social occupational functioning assessment scale. A total of 54% of patients experiences low functioning at follow-up. Attention, Avolition, and Motor-Coordination subscale were significant predictors of low-functioning with an accuracy of 79.7%. A non-significant trend was found for a dopamine-related-gene polymorphism (DRD1-rs4532). The model was independent of psychotic-risk status, DSM-diagnosis, and psychotic conversion. A trans-diagnostic approach taking into account specific neurocognitive, clinical, and neurological information has the potential to identify those individuals with low-functioning independent of DSM diagnosis or the level of psychosis-risk. Specific early interventions targeting modifiable risk factors and emphasize functional recovery in young psychiatric samples, independent of DSM-diagnosis and psychosis-risk, are essential.

Original publication

DOI

10.1016/j.schres.2016.12.019

Type

Journal article

Journal

Schizophr Res

Publication Date

07/2017

Volume

185

Pages

114 - 121

Keywords

Functioning, “CAARMS”, “Genetics”, “Neurocognition”, “Neurological soft signs”, “Ultra high risk”, Adult, Catechol O-Methyltransferase, Cognition Disorders, Female, Humans, Logistic Models, Longitudinal Studies, Male, Mental Disorders, Neuropsychological Tests, Psychiatric Status Rating Scales, Receptors, Dopamine D1, Retrospective Studies, Risk Factors, Young Adult