Journal
SCHIZOPHRENIA RESEARCH
Volume 125, Issue 1, Pages 69-76Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.schres.2010.09.007
Keywords
Psychosis; Ultra high risk symptoms; Premorbid adjustment; Environmental risk factors; Prediction of psychosis
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Funding
- ZON-MW (ZorgOnderzoek Nederland/NWO-Medische Wetenschappen) [2630.0001]
- European Commission in Brussels, Belgium [QLGU-CT-2001-01081]
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BACKGROUND: The onset of schizophrenia is associated with genetic, symptomatic, social and environmental risk factors. The aim of the present study was to determine which environmental factors may contribute to a prediction of a first psychotic episode in subjects at Ultra High Risk (UHR) for developing psychosis. METHOD: We included 72 UHR subjects and followed them over a period of 36 months, of whom nineteen (26.4%) made a transition to psychosis. We applied survival analyses to determine associations between a transition to psychosis and environmental factors and social adjustment. To determine which items are the best predictors of transition to a first psychotic episode, Cox Regression analyses were applied RESULTS: Urbanicity, receiving state benefits and poor premorbid adjustment (PMA) significantly influenced the transition to psychosis. Urbanicity (Wald = 10.096, p = .001, HR = 30.97), social-sexual aspects (Wald = 8.795, p = .003, HR = 1.91) and social-personal adjustment (Wald = 10.794, p = .001, HR = 4.26) appeared to be predictors for developing psychosis in our UHR group. CONCLUSIONS: Environmental characteristics and social adjustment are predictive of transition to a psychosis in subjects at UHR. These characteristics should be implemented in a model for prediction of psychosis. Such a model would be more specific than current models and may lead to patient-specific preventive interventions. (C) 2010 Elsevier B.V. All rights reserved.
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