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Carrión RE. JAMA Psychiatry. 2013;doi:10.1001/jamapsychiatry.2013.1909. http://www.healio.com/psychiatry/schizophrenia/news/online/%7B73a2df32-3a6a-4a01-a5cc-5331ffab4bfd%7D/functional-disability-risks-identified-in-adolescents-with-emerging-psychosis Early neurocognitive performance and functioning were associated with poorer social and functional outcomes in patients at clinical high risk for schizophrenia and psychotic disorders, according to study results published in JAMA Psychiatry. See Also • New genetic risks for schizophrenia identified http://www.healio.com/psychiatry/schizophrenia/news/online/%7B7a8c51e1-1be5-4b8b-8f08-0acecb679a76%7D/new-genetic-risks-for-schizophrenia-identified • Dose reduction, discontinuation benefited psychosis patients ... http://www.healio.com/psychiatry/schizophrenia/news/online/%7B1edfb0bb-dacb-4ee7-b298-51d774d209fd%7D/dose-reduction-discontinuation-benefited-psychosis-patients-in-long-term • Methamphetamine use tied to psychosis http://www.healio.com/psychiatry/schizophrenia/news/online/%7B5cd5ad9c-7397-4014-b145-134a96126182%7D/methamphetamine-use-tied-to-psychosis “We now recognize that adolescents who display early warning signs of later psychiatric illness, especially psychosis, have a variety of functional disabilities that can profoundly influence educational attainment, work objectives and social interactions, even if full psychosis doesn’t develop,” study researcher Ricardo E. Carrión, PhD, of Zucker Hillside Hospital in Glen Oaks, N.Y., told Healio.com. “By identifying individuals vulnerable to later functional disability during adolescence, we expect to develop interventions before illness progression, at a time when treatment will be most effective.” Carrión and colleagues evaluated data from 101 patients seeking treatment in the Recognition and Prevention Program research clinic. The patients were found positive for clinical high risk, as defined by the Scale of Prodromal Symptoms (SOPS). Researchers included 68 participants without a schizophrenia spectrum diagnosis in the control arm (aged 12 to 22 years). Mean 3-year follow-up data were available from 92 of the 101 patients. Results from the Global Functioning (GF): Social and GF: Role scales indicated that 47.8% of the patients had poor social outcomes, whereas 48.9% had poor role outcomes. Poor social and role outcomes were observed in 32.6% of the patients. Researchers found that poor social outcome was associated with poor baseline verbal memory (P<.001), processing speed (P<.001), executive function (P<.001), motor speed (P=.002) and language (P<.001). Processing speed, verbal memory and attention were the only deficits demonstrated by patients with good social outcomes compared with the control group. Overall, poor baseline processing speed (OR=1.38; 95% CI, 1.050-1.823), social functioning (OR=1.85; 95% CI, 1.258-2.732) and a SOPS total disorganization subscale score higher than 4 (OR=5.06; 95% CI, 1.548-16.527) were predictors for poor social outcome. Poor verbal memory at baseline was the highest predictor for poor role outcome (P<.001), followed by processing speed (P<.001), executive function (P<.001), language (P<.001), working memory (P<.001), sustained attention (P=.003) and visuospatial processing (P=.01). Patients with good role outcome demonstrated processing speed impairments compared with the control population. Researchers were able to predict poor role outcome based on baseline verbal memory (OR=1.74; 95% CI, 1.169-2.594), role functioning (OR=1.34; 95% CI, 1.053-1.711) and motor disturbances (OR=1.77; 95% CI, 1.060-2.969). Patient demographic features, current IQ, education level, sex ratio, handedness, socioeconomic status, race and ethnicity did not affect social and role outcomes, according to the researchers. “In light of evidence that a large proportion of individuals at clinical high risk do not develop full-blown psychosis, finding markers that may indentify patients at high risk for functional impairments may provide a pathway to prevent the disability associated with the illness,” Carrión said. “Prevention is needed for emerging psychosis, as well as for helping these individuals cope with persistent relationship and occupational problems.” Disclosure: Researchers report funding from the National Institute of Mental Health and Zucker Hillside Hospital.