Additive effects of a family history of schizophrenia spectrum disorders and an environmental risk score for the outcome of patients with non-affective first-episode psychosis

• Published in: Psychological medicine Vol. 54; no. 10; pp. 2435 - 2443
• Main Authors: Cuesta, Manuel J, García de Jalón, Elena, Sánchez-Torres, Ana M, Gil-Berrozpe, Gustavo J, Aranguren, Lidia, Gutierrez, Gerardo, Corrales, Asier, Zarzuela, Amalia, Ibañez, Berta, Peralta, Víctor
• Format: Journal Article
• Language: English
• Published: England Cambridge University Press 01.07.2024
• Subjects: Adolescent; Adult; Environmental aspects; Etiology; Female; Genetic diversity; Humans; Male; Mental disorders; Patients; Phenotypes; Phenotypic variations; Psychosis; Psychosocial factors; Psychosocial Functioning; Psychotic Disorders - genetics; Recovery; Remission; Remission (Medicine); Risk Factors; Schizophrenia; Schizophrenia - genetics; Social interactions; Sociodemographics; Socioeconomic factors; White people; Young Adult; environmental risk score; RERI; family of schizophrenia spectrum disorder; first-episode psychosis; non-affective psychosis
• ISSN: 0033-2917; 1469-8978; 1469-8978
• DOI: 10.1017/S0033291724000576

First-episode psychotic disorders comprise a heterogeneous phenotype with a complex etiology involving numerous common small-effect genetic variations and a wide range of environmental exposures. We examined whether a family of schizophrenia spectrum disorder (FH-Sz) interacts with an environmental risk score (ERS-Sz) regarding the outcome of patients with non-affective first episode psychosis (NAFEP). We included 288 patients with NAFEP who were evaluated after discharge from an intensive 2-year program. We evaluated three outcome measures: symptomatic remission, psychosocial functioning, and personal recovery. We analyzed the main and joint associations of a FH-Sz and the ERS-Sz on the outcomes by using the relative excess risk due to interaction (RERI) approach. A FH-Sz showed a significant association with poor symptomatic remission and psychosocial functioning outcomes, although there was no significant interaction between a FH-Sz and the ERS-Sz on these outcomes. The ERS-Sz did not show a significant association with poor symptomatic remission and psychosocial functioning outcomes, even though the magnitude of the interaction between ERS-Sz and FH-Sz with the later outcome was moderate (RERI = 6.89, 95% confidence interval -16.03 to 29.81). There was no association between a FH-Sz and the ERS-Sz and personal recovery. Our results provide further empirical support regarding the contribution of FH-Sz to poor symptomatic remission and poor psychosocial functioning outcomes in patients with NAFEP.