Preliminary Findings for Two New Measures of Social and Role Functioning in the Prodromal Phase of Schizophrenia

Recognition and Prevention Program, Department of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, 75-59 263rd Street, Glen Oaks, NY 11004, USA.
Schizophrenia Bulletin (Impact Factor: 8.45). 06/2007; 33(3):688-702. DOI: 10.1093/schbul/sbm029
Source: PubMed


Research on prediction and prevention of schizophrenia has increasingly focused on prodromal (prepsychosis) social and role dysfunction as developmentally early, stable, and treatment-resistant illness components. In this report, 2 new measures, Global Functioning: Social and Global Functioning: Role, are presented, along with preliminary findings about psychometric properties and course of social and role (academic/work) functioning in the prodromal phase of psychosis.
Subjects included 69 participants from the Recognition and Prevention program and 52 from the Center for the Assessment and Prevention of Prodromal States. Ages ranged from 12 to 29 years, and all met criteria for Attenuated Positive Symptom syndrome. Retrospective (past year) and baseline data are reported for all 121 prodromal subjects and for 44 normal controls (NCs). Prospective follow-up data are reported for a subsample of patients reevaluated at both 6 and 12 months (N = 44).
For both scales, interrater reliability was high, and preliminary data supported construct validity. Relative to NCs, prodromal individuals displayed impaired social and role functioning at baseline. Analyses of change over time indicated that role functioning declined over the year before ascertainment and improved over 12-month follow-up, presumably with treatment. Social impairment, by contrast, was constant across time and predicted later psychosis (P = .002).
Using 2 new global measures, social functioning was found to be a stable trait, unchanged by treatment, with considerable potential to be a marker of schizophrenia. Role functioning, by contrast, may be a more direct barometer of clinical change and may be responsive to treatment and environmental change.

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Available from: Andrea M Auther, Dec 19, 2013
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    • "A depression–anxiety composite score was computed from the BPRS, which is based on a recent factor analysis (Kopelozicz et al., 2008) that included the following scale items: anxiety, depression, suicidality, and guilt. Social functioning was measured using the Global Functioning: Social Scale (GF-S; Cornblatt et al., 2007). "
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    • "The degree of symptoms and psychopathology was measured with the Positive and Negative Syndrome Scale (PANSS) Kay et al., 1987). Furthermore, a semi-structured interview was used, and based on this information level of social and role functioning was measured by the Global Functioning: Social (GF: Social) and the Global Functioning: Role (GF: Role) (Cornblatt et al., 2007). A score of six (moderate impairment or above) is required to be considered in remission. "

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