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Decline in social functioning in teens predicts psychosis

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A further decline in social functioning of adolescents who already display significant social deficits might be a risk marker for psychosis in adulthood, according to a researcher.

“The inability to function socially appropriately seems to have tremendous potential to be a very early and clear predictor of early mental illness,” said Barbara A. Cornblatt, Ph.D., of Zucker Hillside Hospital in New York City.

Dr. Cornblatt distinguishes between functional impairment in the social domain – difficulties making friends, increasing social isolation, lack of social support networks – and role of impairment, which is the “inability to maintain age-appropriate roles in the community.”

She and her team follow adolescents and young adults aged 12-22 who are at clinical high risk for psychosis as part of their center’s RAP (Recognition and Prevention) program. They also participate in the NAPLS (North American Prodrome Longitudinal Study) consortium.

They have observed that among clinical high-risk subjects, moderate social problems often are visible early in development, as children join in social activities and try to make friends. Most of these patients appear to have deficits that are stable across development, putting them at risk for future moderate clinical problems and potential disability.

Additionally, there appears to be a subgroup of those with functional social deficits who display a large decline in social interactions typically beginning in their mid-teens, and these progressive deficits might predict later emerging psychosis, Dr. Cornblatt said at the annual meeting of the American Psychiatric Association.

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