Baseline Social Functioning Is Associated with Increased Likelihood of Remission from a Clinical High Risk for...

Most individuals at clinical high risk for psychosis (CHR) will not develop psychosis. Moreover, a proportion of individuals who meet the criteria for a CHR syndrome at one time point stop meeting the criteria at follow-up. It is unknown whether there are specific baseline resiliency factors associated with CHR-positive symptom remission. The literature suggests that among the possible resiliency factors premorbid social functioning may be particularly important. Here, we examine how social functioning at baseline is related to remission status among CHR participants.

A total of 146 CHR and 114 healthy controls were assessed at a baseline and 12 months later. Within the CHR group, 10 individuals transitioned to a psychotic disorder and were excluded, 96 remained CHR, and 40 were fully remitted from CHR status. We compared baseline social functioning between the remitted- and active-CHR groups and examined possible underlying mechanisms such as social anhedonia and severity of interpersonal problems.

CHR individuals who remitted had higher baseline levels of social functioning (t(92) = 3.3, P = .001). Social functioning was related to subsequent CHR group status when controlling for negative and positive symptoms and demographic variables (B = 0.46, SE = 0.19, P = .02). Remitted individuals had higher baseline levels of social pleasure (t(59) = 2.3, P = .03) and lower baseline levels of interpersonal problems (t(11) = 2.4, P = .03).

Our findings identify an important predictor of remission status in CHR patients and suggest that interventions to improve social functioning could have preventative effects.