Self-rated disability in first treated episode of psychosis: A 1-year follow-up study

Abstract

Objectives: Knowledge about self-rated disability over time in psychotic disorders is limited. How self-rateddisability relates to clinician-rated global functioning, self-rated life satisfaction and symptomatology wasinvestigated across thefirst year of treatment in early psychosis. Methods: Participants withfirst treated episode of psychosis (n= 115) were investigated at baseline and 1-yearfollow-up. Self-rated Disability was measured with World Health Organization- Disability Assessment Schedule2.0. Clinician-rated global functioning, self-rated life satisfaction, and symptomatology were measured withappropriate scales. Results: Average self-rated disability infirst-treated episode of psychosis was high, corresponding with the 10%highest in a general population sample. However, 37% werenotdisabled at a clinically significant level afterone year. Self-rated disability was highest in the two social domains (Getting along with people and Participationin society), but improved significantly from baseline to 1-year. At 1-year follow-up self-rated disability hadsignificant weak to medium correlations with clinician-rated global functioning and positive symptoms,and mainly medium to strong correlations with life satisfaction and depressive symptoms. Yet only baselinedepression significantly predicted disability after one year. Conclusion: Self-rated disability infirst treated episode of psychosis is high, but improves across thefirst year,indicating signs of early recovery. Moreover,self-rateddisability isrelated, but distinct fromclinician-ratedglobalfunctioning and self-rated life satisfaction, suggesting that self-rated disability should also be assessed in order tomore fully describe outcomes infirst episode psychosis. Thefindings highlight the need for specialised treatmentof depression and social disability in early psychosis.