6b1d23a4ff2bf2753f433d507bd1ae20  pmc_34199653.pdf
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73daca4890cc29b3c8338530742bf75144054671db03600080621997388d2cfa  pmc_34199653.pdf

Title:           The Role of Premorbid IQ and Age of Onset as Useful Predictors of Clinical, Functional Outcomes, and Recovery of Individuals with a First Episode of Psychosis
Subject:         Background: premorbid IQ (pIQ) and age of onset are predictors of clinical severity and long-term functioning after a first episode of psychosis. However, the additive influence of these variables on clinical, functional, and recovery rates outcomes is largely unknown. Methods: we characterized 255 individuals who have experienced a first episode of psychosis in four a priori defined subgroups based on pIQ (low pIQ < 85; average pIQ  85) and age of onset (early onset < 18 years; adult onset  18 years). We conducted clinical and functional assessments at baseline and at two-year follow-up. We calculated symptom remission and recovery rates using the Positive and Negative Symptoms of Schizophrenia Schedule (PANSS) and the Global Assessment Functioning (GAF or Children-GAF). We examined clinical and functional changes with pair-wise comparisons and two-way mixed ANOVA. We built hierarchical lineal and logistic regression models to estimate the predictive value of the independent variables over functioning or recovery rates. Results: early-onset patients had more severe positive symptoms and poorer functioning than adult-onset patients. At two-year follow-up, only early-onset with low pIQ and adult-onset with average pIQ subgroups differed consistently, with the former having more negative symptoms (d = 0.59), poorer functioning (d = 0.82), lower remission (61% vs. 81.1%), and clinical recovery (34.1% vs. 62.2%). Conclusions: early-onset individuals with low pIQ may present persistent negative symptoms, lower functioning, and less recovery likelihood at two-year follow-up. Intensive cognitive and functional programs for these individuals merit testing to improve long-term recovery rates in this subgroup.
Keywords:        psychosis; first-episode; premorbid intelligence; age at onset; functional outcome; remission; recovery; heterogeneity; subgroup
Author:          Mariola Molina-García, David Fraguas, Ángel del Rey-Mejías, Gisela Mezquida, Ana M. Sánchez-Torres, Silvia Amoretti, Antonio Lobo, Ana González-Pinto, Álvaro Andreu-Bernabeu, Iluminada Corripio, Eduard Vieta, Inmaculada Baeza, Anna Mané, Manuel Cuesta, Elena de la Serna, Beatriz Payá, Iñaki Zorrilla, Celso Arango, Miquel Bernardo, Marta Rapado-Castro, Mara Parellada and on behalf of the PEPs Group
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      Title: Introduction 
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     Item: 
      Title: Methods 
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       Item: 
        Title: Participants 
        Destination: subsection.2.1
       Item: 
        Title: Procedures 
        Destination: subsection.2.2
        Children: 
         Item: 
          Title: Definition of Premorbid IQ and Age of Onset Subgroups 
          Destination: subsubsection.2.2.1
         Item: 
          Title: Clinical Assessment 
          Destination: subsubsection.2.2.2
       Item: 
        Title: Statistical Analyses 
        Destination: subsection.2.3
     Item: 
      Title: Results 
      Destination: section.3
      Children: 
       Item: 
        Title: Sociodemographic and Clinical Characteristics 
        Destination: subsection.3.1
       Item: 
        Title: Pairwise Comparison of Clinical Symptoms, Functioning, Symptom Remission, and Clinical Recovery Rates 
        Destination: subsection.3.2
       Item: 
        Title: Clinical and Functioning Changes over Time 
        Destination: subsection.3.3
       Item: 
        Title: Predictive Value of pIQ and Age of Onset at Baseline over General Functioning at Two-Year Follow-Up 
        Destination: subsection.3.4
     Item: 
      Title: Discussion 
      Destination: section.4
     Item: 
      Title: Conclusions 
      Destination: section.5
     Item: 
      Title: References
      Destination: section.5
   Info: 
    Title: The Role of Premorbid IQ and Age of Onset as Useful Predictors of Clinical, Functional Outcomes, and Recovery of Individuals with a First Episode of Psychosis
    Author: Mariola Molina-García, David Fraguas, Ángel del Rey-Mejías, Gisela Mezquida, Ana M. Sánchez-Torres, Silvia Amoretti, Antonio Lobo, Ana González-Pinto, Álvaro Andreu-Bernabeu, Iluminada Corripio, Eduard Vieta, Inmaculada Baeza, Anna Mané, Manuel Cuesta, Elena de la Serna, Beatriz Payá, Iñaki Zorrilla, Celso Arango, Miquel Bernardo, Marta Rapado-Castro, Mara Parellada and on behalf of the PEPs Group
    Subject: Background: premorbid IQ (pIQ) and age of onset are predictors of clinical severity and long-term functioning after a first episode of psychosis. However, the additive influence of these variables on clinical, functional, and recovery rates outcomes is largely unknown. Methods: we characterized 255 individuals who have experienced a first episode of psychosis in four a priori defined subgroups based on pIQ (low pIQ < 85; average pIQ  85) and age of onset (early onset < 18 years; adult onset  18 years). We conducted clinical and functional assessments at baseline and at two-year follow-up. We calculated symptom remission and recovery rates using the Positive and Negative Symptoms of Schizophrenia Schedule (PANSS) and the Global Assessment Functioning (GAF or Children-GAF). We examined clinical and functional changes with pair-wise comparisons and two-way mixed ANOVA. We built hierarchical lineal and logistic regression models to estimate the predictive value of the independent variables over functioning or recovery rates. Results: early-onset patients had more severe positive symptoms and poorer functioning than adult-onset patients. At two-year follow-up, only early-onset with low pIQ and adult-onset with average pIQ subgroups differed consistently, with the former having more negative symptoms (d = 0.59), poorer functioning (d = 0.82), lower remission (61% vs. 81.1%), and clinical recovery (34.1% vs. 62.2%). Conclusions: early-onset individuals with low pIQ may present persistent negative symptoms, lower functioning, and less recovery likelihood at two-year follow-up. Intensive cognitive and functional programs for these individuals merit testing to improve long-term recovery rates in this subgroup.
    Keywords: psychosis; first-episode; premorbid intelligence; age at onset; functional outcome; remission; recovery; heterogeneity; subgroup
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   Type: CRC32
  Checksum: 6b1d23a4ff2bf2753f433d507bd1ae20
   Type: MD5
  Checksum: 0301faba698fcc8bb97a5153d24bba710e628470
   Type: SHA-1
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   Type: SHA-256