Stressful life events and their association with symptom severity and functioning in first-episode psychosis

Stressful life events (SLEs) are a risk factor for psychosis; however, evidence on the impact of SLEs in individuals with first-episode psychosis (FEP) is limited. The current study draws on longitudinal data from the social mind study (ISRCTN85485447) and examines whether SLEs predict subsequent symptom severity, functioning, and relapse among individuals with first-episode psychosis (FEP). We hypothesised that greater exposure to SLEs at baseline would be associated with poorer clinical outcomes at follow-up. Data from 265 FEP participants across 10 sites in the United Kingdom were examined to investigate the associations between baseline SLEs and changes in symptom severity, functioning, and relapse over a 1-year follow-up. Statistical models were adjusted for age, sex, ethnicity, and site. Greater baseline SLE exposure predicted more severe general psychopathology both across assessment timepoints (p < 0.05) and at 12 months (p < 0.05). Baseline SLEs predicted poorer functioning (measured using GAF symptoms and disability) across assessment timepoints (p < 0.05). Baseline SLE exposure was not associated with increased odds of relapse. In conclusion, this study shows that FEP individuals who were exposed to SLEs prior to baseline exhibited more severe general psychopathology and poorer functioning. SLEs assessment should be integrated into early psychosis care and inform early intervention strategies addressing social stress.