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
Por:
Molina-Garcia, M, Fraguas, D, del Rey-Mejias, A, Mezquida, G, Sanchez-Torres, AM, Amoretti, S, Lobo, A, Gonzalez-Pinto, A, Andreu-Bernabeu, A, Corripio, I, Vieta, E, Baeza, I, Mane, A, Cuesta, M, de la Serna, E, Paya, B, Zorrilla, I, Arango, C, Bernardo, M, Rapado-Castro, M, Parellada, M, PEPs Grp
Publicada:
1 jun 2021
Resumen:
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.
Filiaciones:
Molina-Garcia, M:
Complutense Univ Madrid UCM, Gregorio Maranon Hlth Res Inst IiSGM, Hosp Gen Univ Gregorio Maranon,Inst Psychiat & Me, Sch Med,Dept Child & Adolescent Psychiat,Res Netw, Madrid 28007, Spain
Fraguas, D:
Complutense Univ Madrid UCM, Res Networking Ctr Mental Hlth Network CIBERSAM, Sch Med, Inst Psychiat & Mental Hlth,Hosp Clin San Carlos, Madrid 28040, Spain
del Rey-Mejias, A:
Complutense Univ Madrid UCM, Sch Psychol, Inst Ramon y Cajal Invest Sanitaria IRYCIS, Data Sci Unit,Hosp Univ Ramon y Cajal, Madrid 28223, Spain
Mezquida, G:
Univ Barcelona, Hosp Clin Barcelona, August Pi i Sunyer Biomed Res Inst IDIBAPS, Barcelona Clin,Schizophrenia Unit,Neurosci Inst,R, Barcelona 08036, Spain
Sanchez-Torres, AM:
Complejo Hosp Navarra, Navarra Inst Hlth Res IdiSNA, Dept Psychiat, Pamplona 31008, Spain
Amoretti, S:
Univ Barcelona, Hosp Clin Barcelona, August Pi i Sunyer Biomed Res Inst IDIBAPS, Barcelona Clin,Schizophrenia Unit,Neurosci Inst,R, Barcelona 08036, Spain
Lobo, A:
Univ Zaragoza, Inst Invest Sanitaria Aragon IIS Aragon, Dept Med & Psychiat, Zaragoza 50009, Spain
Gonzalez-Pinto, A:
Univ Basque Country, UPV EHU, Hosp Univ Alava, Dept Psychiat,Bioaraba Hlth Res Inst,Res Networki, Vitoria 01009, Spain
Andreu-Bernabeu, A:
Complutense Univ Madrid UCM, Gregorio Maranon Hlth Res Inst IiSGM, Hosp Gen Univ Gregorio Maranon,Inst Psychiat & Me, Sch Med,Dept Child & Adolescent Psychiat,Res Netw, Madrid 28007, Spain
Corripio, I:
Univ Autonoma Barcelona UAB, Hosp Santa Creu & St Pau, Inst Invest Biomed St Pau IIB ST PAU, Dept Psychiat,Res Networking Ctr Mental Hlth Netw, Barcelona 08041, Spain
Vieta, E:
Univ Barcelona, August Pi i Sunyer Biomed Res Inst IDIBAPS, Inst Neurosci, Hosp Clin,Res Networking Ctr Mental Hlth Network, Barcelona 08036, Spain
Baeza, I:
Univ Barcelona, August Pi i Sunyer Biomed Res Inst IDIBAPS, Hosp Clin Barcelona,Res Networking Ctr Mental Hlt, Child & Adolescent Psychiat & Psychol Dept,SGR 88, Barcelona 08036, Spain
Mane, A:
Autonomous Univ Barcelona, Hosp del Mar Med Res Inst, Res Networking Ctr Mental Hlth Network CIBERSAM, Barcelona 08003, Spain
Cuesta, M:
Complejo Hosp Navarra, Navarra Inst Hlth Res IdiSNA, Dept Psychiat, Pamplona 31008, Spain
de la Serna, E:
Hosp Clin Barcelona, Res Networking Ctr Mental Hlth Network CIBERSAM, Child & Adolescent Psychiat & Psychol Dept, Barcelona 08036, Spain
Paya, B:
Hosp Univ Marques de Valdecilla, IDIVAL, Santander 39008, Spain
Zorrilla, I:
Univ Basque Country, UPV EHU, Hosp Univ Alava, Dept Psychiat,Bioaraba Hlth Res Inst,Res Networki, Vitoria 01009, Spain
Arango, C:
Complutense Univ Madrid UCM, Gregorio Maranon Hlth Res Inst IiSGM, Hosp Gen Univ Gregorio Maranon,Inst Psychiat & Me, Sch Med,Dept Child & Adolescent Psychiat,Res Netw, Madrid 28007, Spain
Bernardo, M:
Univ Barcelona, Hosp Clin Barcelona, August Pi i Sunyer Biomed Res Inst IDIBAPS, Barcelona Clin,Schizophrenia Unit,Neurosci Inst,R, Barcelona 08036, Spain
Rapado-Castro, M:
Complutense Univ Madrid UCM, Gregorio Maranon Hlth Res Inst IiSGM, Hosp Gen Univ Gregorio Maranon,Inst Psychiat & Me, Sch Med,Dept Child & Adolescent Psychiat,Res Netw, Madrid 28007, Spain
Univ Melbourne, Melbourne Neuropsychiat Ctr, 161 Barry St, Carlton, Vic 3053, Australia
Melbourne Hlth, 161 Barry St, Carlton, Vic 3053, Australia
Parellada, M:
Complutense Univ Madrid UCM, Gregorio Maranon Hlth Res Inst IiSGM, Hosp Gen Univ Gregorio Maranon,Inst Psychiat & Me, Sch Med,Dept Child & Adolescent Psychiat,Res Netw, Madrid 28007, Spain
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