Parental socioeconomic status and prognosis in individuals with ultra-high risk for psychosis: A 2-year follow-up study

A possible relationship between socioeconomic status (SES) and the development of mental illness has been continuously suggested. Still, less clear is whether the SES has a direct effect on the development of schizophrenia. In this longitudinal study, we test the hypothesis that parental SES is associated with the prognosis of individuals at ultra-high risk (UHR) for psychosis. One hundred and sixteen individuals who were determined as UHR using a Comprehensive Assessment of At-Risk Mental States (CAARMS) were classified into three groups based on the parental SES levels assessed by the Hollingshead-Redlich scale. There were no differences in the Positive and Negative Syndrome Scale (PANSS), the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS) and the Brief Psychiatric Rating Scale (BPRS) at baseline. However, at the 1-year follow-up, the higher versus lower SES group showed significant differences in clinical measures including SAPS, SANS, PANSS positive and negative scales as well as BPRS scores. Most of these clinical differences were attenuated by the second year of follow-up with no sign of an increased rate of conversion to psychosis derived from a socioeconomically disadvantaged status. However, SAPS and PANSS positive scale still revealed sub-threshold positive symptoms within the low SES group at the 2-year follow-up. Moreover, especially for the subjects who continued the follow-ups for 1year and/or 2years, the changes of clinical symptoms between the baseline and follow-ups showed that there were significant symptom changes in higher and middle SES groups within the 1-year period already, but the lower SES group showed significant recovery at the second year. Our findings suggest that low parental SES can be detrimental to the prognosis phase of individuals at UHR. Limited supportive socioeconomic resources may slow the rate of symptom recovery in UHR subjects.