Functional deterioration in individuals with schizophrenia spectrum personality symptoms

Although previous studies have noted functional deterioration in patients with severe schizotypal symptoms who meet criteria for schizotypal personality disorder, we are not aware of any study which examines level of functioning in nonpatients who experience mild schizophrenia spectrum personality (SSP) symptoms. With this issue in mind, occupational functioning was examined in non-patient subjects with mild SSP symptoms. Patients were recruited from the community by newspaper advertisements or from the first-degree relatives of patients with schizophrenia. Individuals with no DSM-IIIR Axis I diagnosis and with SSP symptoms (n = 60) and without symptoms (n = 75) participated in the study. The two groups had similar mean age and years of education. Occupational function was evaluated using the Level of Function Scale. The SSP patients with mild symptoms had significantly lower occupational scores (5.62 + 2.50) than the non-SSP patients (7.76 + 0.69; p < 0.001). A total of 39% of SSP patients, compared with 3% of non-SSP patients showed poor occupational functioning (chi 2 = 31, df = 1, p < 0.001). There was a significant deterioration in the socioeconomic status in SSP patients compared with their parents' status. Patients with mild SSP symptoms who were otherwise healthy showed severe difficulties with occupational function. Further research is needed to identify subtle deficits underlying functional deterioration and to develop targets for treatment strategies.