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Tijdschrift voor Psychiatrie 56 (2014) 1, 40 - 49

Review article

Social dysfunction of young persons with an ultra high risk of developing first-episode psychosis

E. Velthorst, L. de Haan

background Schizophrenia is associated with severe social deficits. Social dysfunction is common in young persons with an ultra high risk (uhr) of developing a psychotic disorder.
aim To present an overview of the literature on social deficits in the uhr phase, and to find out what role these deficits play in the prediction of a first psychotic episode.
method We searched the literature using Psycinfo (covering the period from 1995 to January 2013) in order to locate articles relating to the role of social dysfunction in the uhr phase.
results Young persons who meet one or more uhr criteria face more social constraints than the general population. Effect-sizes indicate differences ranging from medium to substantial (range Cohen’s d = .63 – 4.18). Impairments in both social and role functioning contribute to the prediction of a first psychotic episode in uhr young persons.
conclusion Research conducted on uhr adolescents shows, without exception, that functional limitations are already manifest in the phase preceding a clinical psychotic disorder. The experiencing of uhr symptoms is itself associated with (severe) social deficits that require treatment, regardless of whether the help-seeking uhr individual eventually develops a psychosis.

keywords prediction, psychosis, social functioning, transition, uhr