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.
© 2019 John Wiley & Sons Australia, Ltd.
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