The role of self-esteem for outcome in first-episode psychosis.

BACKGROUND

Self-esteem may be associated with a wide range of psychiatric disorders, including psychotic disorders. However, the relationship between self-esteem and outcome in psychosis has not been adequately examined, especially early in the course of the illness.

AIM

The aim of the study was to examine the impact of self-esteem in individuals who presented for treatment of a first episode of psychosis on outcome early in the course of the illness.

METHODS

The Self-Esteem Rating Scale (SERS) was administered to 121 individuals with first-episode psychosis following entry into a specialized programme. Symptoms and the Global Assessment of Functioning (GAF) were assessed at six months after beginning treatment. A correlational analysis was followed by a linear regression controlling for potential confounds.

RESULTS

Self-esteem assessed early in the course of treatment was positively correlated with GAF at six months (r = 0.281, p < 0.01). A linear regression analysis conducted with GAF and depression at baseline in addition to gender, pre-morbid adjustment, duration of untreated psychosis (DUP), and self-esteem as predictors and GAF at six months as the outcome variable revealed only self-esteem to be a significant predictor of GAF at six months (β = 0.290, p < 0.01). However, no association was found between self-esteem and remission at six months (β = 0.003, p > 0.05).

CONCLUSION

Self-esteem is associated with global functional outcome at six months but not with remission of symptoms. Efforts should be made to provide interventions that may improve low self-esteem in the attempt to influence functional outcome.