Abstract
Objective: Most studies have investigated either the singular or relative contributions of premorbid adjustment, verbal memory and symptom remission to functional outcomes in first-episode psychosis. Fewer studies have examined the pathways of these factors in impacting functioning. Our study addresses this gap. The objective was to determine whether the relationship between premorbid adjustment and functional outcomes was mediated by verbal memory and symptom remission. Method: A total of 334 first-episode psychosis participants (aged 14–35 years) were assessed on premorbid adjustment, verbal memory upon entry, and positive and negative symptom remission and functioning at multiple time points over a 2-year follow-up. Results: Mediation analyses showed that over the first year, the relationship between premorbid adjustment and functioning was mediated by verbal memory and positive symptom remission (β = –0.18; 95% confidence interval = [–0.51, –0.04]), as well as by verbal memory and negative symptom remission (β = –0.41; 95% confidence interval = [–1.11, –1.03]). Over 2 years, the relationship between premorbid adjustment and functioning was mediated by verbal memory and only negative symptom remission (β = –0.38; 95% confidence interval = [–1.46, –0.02]). Conclusion: Comparatively less malleable factors (premorbid adjustment and verbal memory) may contribute to functional outcomes through more malleable factors (symptoms). Promoting remission may be an important parsimonious means to achieving better functional outcomes.
| Original language | English |
|---|---|
| Pages (from-to) | 793-803 |
| Number of pages | 11 |
| Journal | Australian and New Zealand Journal of Psychiatry |
| Volume | 52 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 1 Aug 2018 |
Bibliographical note
Funding Information:The work was funded by operating grants from the Canadian Institutes of Health Research under Grant #68961.
Funding Information:
G.J. has received funds to support his graduate studies from the Department of Psychiatry at McGill University, Fonds de recherche du Québec-Santé and the Canadian Institutes of Health Research. F.V. has received funding from Fonds de recherche du Québec-Santé. M.L. has received funding from the Sackler Foundation, The James McGill Professorship and Fonds de recherche du Québec-Santé. R.J. has received funds from Fonds de recherche du Québec-Santé and the Canadian Institutes of Health Research. He sits on the advisory boards and speakers’ bureaus of Pfizer Canada and Janssen Ortho Canada; he has received grant funding from them and from AstraZeneca. He has received honoraria from Janssen Ortho Canada for CME presentations and royalties for Henry Stewart talks. A.M. has received funds from Fonds de recherche du Québec-Santé, National Institutes of Health Research and the Canadian Institutes of Health Research. He is also funded through the Canada Research Chair Program and has received research funding, unrelated to this study, from BMS, Pfizer, Otsuka and Lundbeck as well as honoraria related to CME lectures and advisory board participation from BMS, Otsuka, Sunnovian, Lundbeck and Pfizer. S.N.I. is funded by Fonds de recherche du Québec-Santé and the Canadian Institutes of Health Research.
Publisher Copyright:
© The Royal Australian and New Zealand College of Psychiatrists 2017.
Keywords
- Early psychotic disorders
- first-episode psychosis
- functioning
- mediation
- symptom remission
ASJC Scopus subject areas
- Psychiatry and Mental health
