Social and role functioning in youth at risk of serious mental illness

Early Interv Psychiatry. 2020 Aug;14(4):463-469. doi: 10.1111/eip.12872. Epub 2019 Sep 10.


Aim: Functional impairment is common in serious mental illness (SMI). This study assessed social and role functioning in a sample of youth at risk of SMI who met different stages of risk based on a transdiagnostic clinical staging model described by McGorry and colleagues.

Method: The sample consisted of 243 male and female youths aged 12-26 and included: non-help-seeking youth with risk factors (stage 0; n = 41); youth with mild symptoms (stage 1a; n = 52); youth with attenuated psychiatric syndromes (stage 1b; n = 108); and healthy controls (HCs; n = 42). Social and role functioning were assessed with the Global Functioning: Social and Role scales.

Results: Participants in stage 1b (attenuated syndromes) had significantly poorer social and role functioning than stage 0 participants and HCs (P < .001) and poorer social functioning than stage 1a (P < .05). Stage 1a participants had significantly poorer social functioning than HCs (P < .01) and significantly poorer role functioning than stage 0 participants (P < .01). Participants in stages 1a and 1b did not significantly differ from each other in role functioning only.

Conclusions: This study demonstrates that mild to moderate functional impairments are present in young people experiencing subthreshold psychiatric symptoms and distress in the absence of a diagnosable mental illness. Results partially validate the model in that social although not role functioning declines across the stages.

Keywords: at-risk; attenuated syndromes; clinical staging model; functional outcome; youth mental health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Case-Control Studies
  • Child
  • Female
  • Humans
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / psychology*
  • Prodromal Symptoms
  • Risk Factors
  • Role
  • Social Interaction
  • Young Adult