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

Knowledge about self-rated disability over time in psychotic disorders is limited. How self-rated disability relates to clinician-rated global functioning, self-rated life satisfaction and symptomatology was investigated across the first year of treatment in early psychosis. Participants with first treated episode of psychosis (n = 115) were investigated at baseline and 1-year follow-up. Self-rated Disability was measured with World Health Organization- Disability Assessment Schedule 2.0. Clinician-rated global functioning, self-rated life satisfaction, and symptomatology were measured with appropriate scales. Average self-rated disability in first-treated episode of psychosis was high, corresponding with the 10% highest in a general population sample. However, 37% were not disabled at a clinically significant level after one year. Self-rated disability was highest in the two social domains (Getting along with people and Participation in society), but improved significantly from baseline to 1-year. At 1-year follow-up self-rated disability had significant 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 baseline depression significantly predicted disability after one year. Self-rated disability in first treated episode of psychosis is high, but improves across the first year, indicating signs of early recovery. Moreover, self-rated disability is related, but distinct from clinician-rated global functioning and self-rated life satisfaction, suggesting that self-rated disability should also be assessed in order to more fully describe outcomes in first episode psychosis. The findings highlight the need for specialised treatment of depression and social disability in early psychosis. •Self-rated disability improves the first year of treatment in first episode psychosis, providing hope for recovery•It is important to also assess self-rated disability to fully assess outcome in first treated episode of psychosis•Self-rated disability is closely related to depression in first treated episode of psychosis•Treatment of depression and social disability is important alongside psychotic symptoms in first episode psychosis