Differences in psychosocial functioning between psychotic disorders in the Finnish SUPER study.

Area of Science:

• Psychiatry
• Clinical Psychology
• Public Health

Background:

• Psychotic disorders exhibit variable impacts on psychosocial functioning.
• Direct comparative studies on psychosocial functioning across schizophrenia, schizoaffective disorder (SAD), bipolar disorder (BD), and psychotic major depressive disorder (MDD) are limited.

Purpose of the Study:

• To compare psychosocial functioning and its determinants among individuals with schizophrenia, SAD, BD, and psychotic MDD.
• To analyze rates of independent living, employment, marriage, and parenthood within these diagnostic groups.

Main Methods:

• Cross-sectional analysis of 9,148 participants (aged 18-65) from the Finnish SUPER study.
• Data collection included healthcare register information on diagnoses, age of onset, and hospitalizations, alongside interviews on psychosocial functioning.
• Logistic regression models were used to assess associations between demographic/clinical factors and functioning.

Main Results:

• Bipolar disorder (BD) was associated with the best psychosocial functioning, while schizophrenia showed the worst outcomes.
• Significant differences were observed in independent living rates (OR 4.06 for BD vs. schizophrenia).
• Female gender and a lower number of hospitalizations independently predicted better employment, marriage, and independent living across all diagnostic categories.

Conclusions:

• Psychosocial functioning and outcomes vary substantially among psychotic disorders, with schizophrenia faring worst and BD best.
• Independent living showed the most pronounced differences between diagnostic groups.
• Female gender and hospitalization history are critical independent predictors of psychosocial outcomes in psychotic disorders.