Investigating the psychological typology of social recovery in individuals with first episode psychosis

Background Social disability has long been linked with psychosis. However, at what stage disability occurs, whether it exists for all individuals, and factors predicting outcome are still under debate. Assessing social functioning in first episode psychosis (FEP) presents a methodological challenge as many existing tools were developed for chronic schizophrenia and are confounded with psychotic symptoms. Aims This study explored the prevalence and typology of social disability in FEP. Different trajectories of social recovery were examined as well as predictors of outcome. Method A sample of 878 individuals with FEP were assessed upon entry into Early Intervention for Psychosis (EIP) services and followed up over 12 months. Social disability was assessed using weekly hours engaged in structured activity on the Time Use Survey (TUS). Recovery profiles were examined using two approaches: transition between clinical and non-clinical cut-off scores on the TUS, and Latent Class Growth Analysis. Baseline predictors of outcome were examined using ordinal and multinomial regression. Results At baseline, over 80% of participants scored below the non-clinical cut-off of 45 hours per week in structured activity. Male gender and poor premorbid adjustment in adolescence predicted baseline levels of social disability. Over 50% of participants remained socially disabled following 12 months of EIP service provision. Social recovery over the 12 month study period was predicted by baseline time use, gender, Typology of Social Recovery from FEP J. Hodgekins iii ethnicity, age of onset of psychosis, duration of untreated psychosis, negative symptoms, and premorbid adjustment in adolescence. Conclusion Social disability is prevalent in FEP, although a significant minority do not experience any social disability and make a full social recovery. Where social disability is present upon entry into EIP services it can remain stable over time. Social disability may occur in adolescence, even before the onset of psychotic symptoms. The clinical and theoretical implications of the findings are discussed.

Name dc:type.qualificationname

other

Level dc:type.qualificationlevel

doctoral

Grantor dc:publisher.institution

University of East Anglia

Year dc:date.issued

2012

Author dc:creator

• Hodgekins, Joanne

Language dc:language

en