Aim: There is a growing appreciation that subthreshold but clinically elevated levels of autistic traits are clinically relevant. This study examined autistic traits in Singaporean patients with first‐episode psychosis and their association with 1‐year psychosis recovery.Methods: The relationship between baseline patient characteristics, autistic traits (measured with autism screening questionnaires) and psychosis recovery outcomes at 1‐year were examined in 180 adults in the Early Intervention Psychosis Programme in Singapore.Results: Out of 180 participants, 50 (27.8%) had clinically elevated above screening‐cut off levels of autistic traits on the self‐reported 10‐item Autism Spectrum Quotient and 8 (4.4%) on the staff‐rated Autism Spectrum Disorder in Adults Screening Questionnaire. At baseline, those with more autistic traits were more likely to be unemployed, economically inactive (ie, students or homemakers); and to have diagnoses of mood disorder with psychotic features, brief psychotic disorder or psychotic disorder not otherwise specified as compared to schizophrenia spectrum and delusional disorder diagnoses. Although most participants showed improvements in their clinical outcomes at 1‐year, those with higher autistic traits improved less in the Positive and Negative Syndrome Scale general psychopathology scale and in Global Assessment of Functioning symptomatology.Conclusions: Autistic traits are common in those with first‐episode psychosis and may be associated with poorer clinical outcomes. Validated screening tools should be developed in this population to support earlier reporting.

Quality of life (QoL) is often used as an outcome assessment in programs treating patients with first-episode psychosis (FEP). The aim of this study was to examine the longitudinal trend of subjective QoL among patients with FEP and identify the potential influence of patients' social-demographic/lifestyle factors on the trend of QoL. Two hundred and eighty subjects participated in the study. Patient's demographics and subjective QoL were collected at baseline, 6 months and 1 year follow-up. Data were analyzed with a fixed-effect general linear regression model. Subjective QoL demonstrated significant trends of improvement in all four subdomains (physical health, psychological health, social relationships, and environment). Compared with unemployed participants, employed participants were significantly associated with better social relationships (p = 0.005) and environment (p = 0.029) after adjusting for age and gender. Moderation analysis demonstrated a significant improvement of physical health, social relationships, and environment for participants with a higher level of educational achievement, but not for participants with a lower level of educational achievement. Our results indicate that patients with FEP experienced significant improvement in subjective QoL over a 1 year period. Being employed was associated with overall better social relationships and environment among patients with FEP and higher educational achievement was associated with improvement of physical health, social relationship, and environment. Hence, educational achievement and employment could be considered for future optimization of early psychosis intervention programs.

From The Journal of Clinical Psychiatry: As many as 25% of patients with first-episode psychosis experience nonremission or treatment resistance. Read this article to see whether initiating clozapine earlier in treatment can lead to better results.

This cross-sectional study investigated the relationship of religiosity, the use of positive and negative religious coping methods, and quality of life (QOL) among 364 outpatients with psychosis in Singapore. Positive religious coping was significantly associated with better scores on physical (β = 0.51, p = 0.02) and psychological (β = 0.64, p = 0.01) QOL domains in the regression model. Negative religious coping was related to worse QOL in all four domains: physical (β = −0.44, p = 0.03), psychological (β = −0.76, p < 0.01), social (β = −0.54, p = 0.03), and environment (β = −0.65, p < 0.01). Increased participation in organizational religious activities was positively associated with higher QOL for psychological (β = 2.47, p < 0.01), social relationships (β = 2.66, p = 0.01), and environment (β = 2.09, p = 0.01) domains. Interestingly, those with no religious affiliation were found with higher scores in the QOL domain for social relationships (β = 4.59, p = 0.02). Religious coping plays an important role for the QOL of outpatients with psychosis. Greater awareness of the importance of religion in this population may improve cultural competence in treatment. Individuals with psychosis may benefit from greater community support and collaboration between clinical and religious community-based organizations to improve social integration and QOL.