Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Apr;9(2):100-7.
doi: 10.1111/eip.12086. Epub 2013 Aug 22.

Self-awareness of functional impairment in individuals at clinical high-risk for psychosis

Doreen M Olvet  1 , Ricardo E Carrión, Andrea M Auther, Barbara A Cornblatt
Affiliations

Self-awareness of functional impairment in individuals at clinical high-risk for psychosis

Doreen M Olvet et al. Early Interv Psychiatry. 2015 Apr.

Abstract

Aims: A major public health concern associated with schizophrenia is the long-term disability that involves an inability to function independently in the community. An individual's self-awareness of functional impairment may be a significant factor contributing to long-term disability. In fact, subjective interpretation of one's illness impacts treatment participation and adherence, and is linked to poor outcomes. However, it remains unclear how illness-related functional impairment is perceived by individuals prior to the onset of psychosis. This study aims to examine the relationship between clinician-based and self-report assessments of functioning, as well as the contribution of clinical symptoms to this relationship in individuals at clinical high-risk for psychosis.

Methods: The Sheehan Disability Scale, a self-rated instrument, was used to measure disruption in daily functioning in social and role functioning due to symptoms in a sample of 73 treatment-seeking patients at clinical high-risk for psychosis and 50 healthy controls.

Results: Relative to healthy controls, clinical high-risk patients self-reported significant disruptions in social and role functioning. In addition, a specific relationship emerged in that clinician-rated measures of functioning and depression were related to subjective functioning.

Conclusions: These findings suggest that clinical high-risk patients are significantly disturbed by their illness. Self-reported disruption of daily functioning was associated with clinician-rated functioning and depressive symptoms, further highlighting the impact of functional impairments on the level of distress experienced by patients in the early phases of the illness. Intervention strategies that repair functional impairment before the onset of psychosis may prevent long-term disability.

Keywords: clinical high-risk; depression; functional impairment; prodrome; psychosis.

PubMed Disclaimer

References

    1. World Health Organization . The World Health Report 2004: Changing History, Annex Table 3: Burden of disease in DALYs by cause, sex, and mortality stratum in WHO regions, estimates for 2002. Geneva: 2004.
    1. Merikangas KR, Ames M, Cui L, Stang PE, Ustun TB, Von Korff M, et al. The impact of comorbidity of mental and physical conditions on role disability in the US adult household population. Arch Gen Psychiatry. 2007;64(10):1180–8. - PMC - PubMed
    1. Rossler W, Salize HJ, van Os J, Riecher-Rossler A. Size of burden of schizophrenia and psychotic disorders. Eur Neuropsychopharmacol. 2005;15(4):399–409. - PubMed
    1. Wu EQ, Birnbaum HG, Shi L, Ball DE, Kessler RC, Moulis M, et al. The economic burden of schizophrenia in the United States in 2002. J Clin Psychiatry. 2005;66(9):1122–9. - PubMed
    1. Bellack AS, Morrison RL, Wixted JT, Mueser KT. An analysis of social competence in schizophrenia. Br J Psychiatry. 1990;156:809–18. - PubMed

Publication types