Social functioning in individuals at clinical high risk for psychosis
Open accessAbstract
Poor social functioning is a hallmark of schizophrenia. The purpose of this study was to examine social functioning in individuals at clinical high risk for psychosis. Social functioning was assessed in a sample of 86 clinical high risk (CHR) individuals and compared to that of 50 first-episode of psychosis (FE) subjects, 53 multi-episode schizophrenia subjects (ME) and 55 non-psychiatric controls (NPC). Subjects were assessed on the Social Functioning Scale (SFS), the Role Functioning subscale of the Quality of Life Scale (QLS-role), and the premorbid functioning scale. On the SFS, the CHR group did not differ significantly from the FE and ME groups and all were impaired relative to the NPCs. On QLS-role, the CHR group performed significantly better than the ME patients and significantly worse than NPCs. CHR subjects did not differ from patients in terms of premorbid functioning. This study demonstrates that even at the pre-psychotic phase of the illness, these young people are demonstrating significant deficits in social functioning, supporting that social deficits are present long before the onset of psychotic symptoms.
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A significant decline in social functioning has been found across all stages of psychosis, from clinical high risk, first episode of psychosis to chronic schizophrenia.
“A significant decline in social functioning has been found across all stages of psychosis, from clinical high risk (CHR), and first episode of psychosis (FEP) to chronic schizophrenia (SZ) (Abel and Minor 2021; Addington et al. 2008; Raghavan et al. 2017)”
From Social Functioning Interventions in Psychosis: A Systematic Review. (2025) · cites this paper as Addington et al. 2008
The Abstract and Discussion report impaired social functioning in clinical-high-risk, first-episode, and multi-episode groups relative to non-psychiatric controls. They do not establish a significant decline from one stage to the next: the Abstract says the three groups did not differ significantly on the Social Functioning Scale. (LLM, conf=0.86)
Experimental — accuracy not yet measuredA decline in social functioning is a hallmark of psychosis and often emerges before illness onset and typically develops into long-standing difficulties.
“A decline in social functioning is a hallmark of psychosis and often emerges before illness onset and typically develops into long‐standing difficulties (Addington et al. 2008; Carrión et al. 2013; Robinson et al. 2004).”
From Social Functioning Interventions in Psychosis: A Systematic Review. (2025) · cites this paper as Addington et al. 2008
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- Authors
- Addington, J., Penn, D., Woods, S. W., Addington, D., & Perkins, D. O.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- University of North Carolina at Chapel Hill (US)
- Yale University (US)
- University of Calgary (CA)
- Corresponding author
- Addington, Jean
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2008-02
- Volume
- 99
- Issue
- 1-3
- Pages
- 119-124
- ISSN
- 0920-9964 (ISSN-L)
- PMC
- PMC2292799
- OpenAlex
- W2060028231
- Cited by
- 265
- References
- 25
- Citations by year
- 2026: 10 · 2025: 13 · 2024: 11 · 2023: 11 · 2022: 9 · 2021: 20 · 2020: 18 · 2019: 20 · 2018: 15 · 2017: 20 · 2016: 16 · 2015: 16 · 2014: 11 · 2013: 18 · 2012: 14
- FWCI
- 5.17
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- Research Bank (Australian Catholic University) (submittedVersion)
- UNC Libraries
- Funders
- Canadian Institutes of Health Research
- National Institute of Mental Health (U01MH066134, U01MH06634, U01MH066160, U01MH066069, U10MH066160, U01MH06634-02)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- social functioning, clinical high risk for psychosis
- MeSH terms
- Adolescent, Adult, Age Factors, Child, Chronic Disease, Employment, Female, Humans, Male, Psychotic Disorders, Quality of Life, Risk Factors, Role, Schizophrenia, Schizophrenic Psychology, Schizotypal Personality Disorder, Social Adjustment, Social Environment, Genetic Predisposition to Disease
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