What does really matter in the premorbid background of psychosis leading to long-term disability? a 21-year follow-up cohort study of first-episode psychosis

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dc.contributor.authorPeralta Martín, Víctor
dc.contributor.authorGarcía de Jalón, Elena
dc.contributor.authorMoreno-Izco, Lucía
dc.contributor.authorSánchez Torres, Ana María
dc.contributor.authorGil Berrozpe, Gustavo José
dc.contributor.authorPeralta, David
dc.contributor.authorJanda-Galán, Lucía
dc.contributor.authorCuesta, Manuel J.
dc.contributor.authorSEGPEPs Group
dc.contributor.departmentCiencias de la Saludes_ES
dc.contributor.departmentOsasun Zientziakeu
dc.contributor.funderGobierno de Navarra / Nafarroako Gobernua
dc.date.accessioned2025-07-18T16:32:00Z
dc.date.issued2025-05-01
dc.date.updated2025-07-18T16:11:21Z
dc.description.abstractBackground: clinicians are currently unable to predict which patients are at higher risk of long-term disability based on premorbid factors. We aimed to determine the extent to which premorbid factors could prospectively predict long-term disability in patients with first-episode psychosis. Methods: we assessed 12 potential premorbid risk factors in 243 individuals with first-episode psychosis reassessed 21 years later for several domains of psychosocial disability. Hierarchical multivariate regression and Directed Acyclic Graphs (DAGs) were used sequentially to investigate independent and causal associations between risk factors and long-term disability. Results: the familial load of schizophrenia, lower parental SES, obstetric complications, early neurodevelopmental delay, childhood adversity, and poor adolescence social networks were independent predictors of long-term disability, accounting for 40.6 % of the variability. The DAGs analysis showed that both familial risk of schizophrenia and lower SES had statistically significant direct and indirect effects on later disability. The indirect effects were mediated by the variables indexing impaired development, although childhood adversity and poor adolescence social networks also had significant direct effects on disability. Early neurodevelopmental delay was the only developmental marker present in all statistically significant indirect paths from familial background factors to long-term disability, suggesting that it is a key component of the causal chain that leads to later disability. Conclusions: in individuals with psychotic disorders, familial background factors appear to trigger a complex and multidetermined cascade of risk factors across developmental stages that interact iteratively, leading to long-term disability.en
dc.description.sponsorshipThis work was supported by the Spanish Ministry of Economy, Industry and Competitiveness (VP, grant numbers PI16/02148 ; EGJ and MJC, 19/01698), and the Regional Government of Navarra (VP, grant number 31/17), (LMI, grant number 41/18).
dc.embargo.lift2026-05-01
dc.embargo.terms2026-05-01
dc.format.mimetypeapplication/pdf
dc.format.mimetypeapplication/msword
dc.identifier.citationPeralta, V., García de Jalón, E., Moreno-Izco, L., Sánchez-Torres, A. M., Gil-Berrozpe, G. J., Peralta, D., Janda, L., Cuesta, M. J. (2025) What does really matter in the premorbid background of psychosis leading to long-term disability? a 21-year follow-up cohort study of first-episode psychosis. Schizophrenia Research, 279, 31-39. https://doi.org/10.1016/j.schres.2025.02.009.
dc.identifier.doi10.1016/j.schres.2025.02.009
dc.identifier.issn0920-9964
dc.identifier.urihttps://academica-e.unavarra.es/handle/2454/54420
dc.language.isoeng
dc.publisherElsevier
dc.relation.ispartofSchizophrenia Research 279, 2025, 31-39
dc.relation.projectIDinfo:eu-repo/grantAgreement/MINECO//PI16%2F02148/ES/
dc.relation.projectIDinfo:eu-repo/grantAgreement/ISCIII/Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020 (ISCIII)/PI19%2F01698/ES/
dc.relation.projectIDinfo:eu-repo/grantAgreement/Gobierno de Navarra///
dc.relation.publisherversionhttps://doi.org/10.1016/j.schres.2025.02.009
dc.rights© 2025 Elsevier B.V. This manuscript version is made available under the CC-BY-NC-ND 4.0
dc.rights.accessRightsinfo:eu-repo/semantics/embargoedAccess
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectPsychosisen
dc.subjectOutcomeen
dc.subjectDisabilityen
dc.subjectPremorbiden
dc.subjectRisk factorsen
dc.subjectDAGsen
dc.titleWhat does really matter in the premorbid background of psychosis leading to long-term disability? a 21-year follow-up cohort study of first-episode psychosisen
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/acceptedVersion
dspace.entity.typePublication
relation.isAuthorOfPublication6cfdb372-fb89-4760-b1b8-404b0f0ae941
relation.isAuthorOfPublication377cf360-8d08-46f8-b10d-0785571f24c4
relation.isAuthorOfPublication.latestForDiscovery6cfdb372-fb89-4760-b1b8-404b0f0ae941

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