Cross-Cutting Symptom Domains Predict Functioning in Psychotic Disorders.

Autor:	Longenecker JM; Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada.; University of Minnesota, Minneapolis, Minnesota.; Current affiliation: VISN 4 Mental Illness Research, Education and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania., Bagby RM; University of Toronto, Toronto, Ontario, Canada., McKenzie K; Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada.; University of Toronto, Toronto, Ontario, Canada., Pollock BG; Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada.; University of Toronto, Toronto, Ontario, Canada., George TP; Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada.; University of Toronto, Toronto, Ontario, Canada., Voore P; Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada., Quilty LC; Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada.; University of Toronto, Toronto, Ontario, Canada.; Corresponding author: Lena C. Quilty, PhD, 1025 Queen St W, Ste 6405, Toronto, ON, M6J 1H1 (lena.quilty@camh.ca).
Jazyk:	angličtina
Zdroj:	The Journal of clinical psychiatry [J Clin Psychiatry] 2021 Feb 23; Vol. 82 (2). Date of Electronic Publication: 2021 Feb 23.
DOI:	10.4088/JCP.20m13288
Abstrakt:	Objective: Previous research shows elevated disability in psychotic disorders. However, co-occurring symptomatology has been increasingly highlighted as predictive of clinical outcomes in the psychotic spectrum. The current study investigates how both psychotic and nonpsychotic symptom domains predict functioning across psychotic disorders. Methods: Outpatients (N = 128) with psychotic spectrum diagnoses participated in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5) Field Trials at the Centre for Addiction and Mental Health in Toronto, Canada, in 2011, including the repeated administration of "cross-cutting" brief screening measures that assessed internalizing (eg, anxiety, depression), substance use (eg, alcohol, psychoactive drug use), and psychotic symptoms. Level of functioning was also assessed by self-report and clinician-rated World Health Organization Disability Assessment Schedule 2.0 (WHO-DAS-II). The relation between symptom domains and disability was examined concurrently and prospectively via hierarchical regression. Results: Psychosis was strongly linked to self-reported disability when considered in isolation (β = 0.22, P < .001; R2 = 0.11). However, when all 3 symptom domains were included in analyses, internalizing symptoms were the strongest concurrent (β = 0.31, P < .001; R2 = 0.17) and prospective (β = 0.29, P < .001; R2 = 0.15) predictor of disability. In the concurrent model, an interaction between internalizing and substance use emerged, wherein high internalizing symptoms were particularly detrimental in persons with high levels of substance use (β = 0.08, P < .05; R2 = 0.014). Results were similar for clinician-rated WHO-DAS-II. Conclusions: This research supports the potential clinical utility of rapid screening tools available in the newest psychiatric diagnostic manual. The internalizing symptom domain was the strongest predictor of functional outcome for outpatients with psychotic disorders. The results highlight the relevance of a broad range of symptoms, including those that fall outside the primary psychiatric concern, in recovery-oriented clinical work in psychosis. (© Copyright 2021 Physicians Postgraduate Press, Inc.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu