Aim To evaluate whether internalized stigma predicts social anxiety, functioning, and subjective recovery in first episode psychosis differently between group cognitive-behavioral therapy that addressed internalized stigma and cognitive remediation. Methods Data was derived from a randomized controlled trial comparing group cognitive-behavioral therapy for social anxiety with group cognitive remediation in 96 first-episode psychosis participants (18-35 years) with social anxiety disorder. Social anxiety, internalized stigma, functioning, and subjective recovery were assessed at baseline, post-intervention, three and six months later. Results Linear mixed models revealed a significant positive effect of internalized stigma on social anxiety, functioning, and subjective recovery, with no significant interaction between internalized stigma and treatment group, nor with each time point for all three outcomes. Conclusion Results show that internalized stigma did predict improved outcomes but was not specific to group cognitive-behavioral therapy, relative to group cognitive remediation in the current sample, suggesting a general therapeutic benefit of group therapy.

Aim: Patient-reported outcome measures (PROMs) provide valuable information and promote shared decision-making but are infrequently used in psychosis. Self-Rated Health (SRH) and Self-Rated Mental Health (SRMH) are single-item PROMs in which respondents rate their health and mental health from ‘poor’ to ‘excellent’. We examined the psychometric properties of the SRH and SRMH in early intervention for psychosis contexts in Chennai, India and Montreal, Canada. Methods: Assessments were completed in Tamil/English in Chennai and French/English in Montreal. Test-retest reliability included data from 59 patients in Chennai and Montreal. Criterion validity was examined against clinician-rated measures of depression, anxiety, positive and negative symptoms, and a quality-of-life PROM for 261 patients in Chennai and Montreal. Results: SRH and SRMH had good to excellent test-retest reliability (ICC>0.63) at both sites and in English and Tamil (but not French). Results for criterion validity were mixed. Whereas in Montreal, low SRH was associated with not being in positive symptom remission, and poorer functioning and quality of life, SRH was associated only with functioning in Chennai. No associations were found for SRMH in Montreal. In Chennai, however, low SRMH was associated with not being in positive symptom remission and poorer functioning. Conclusions: Our work advances knowledge of more feasibly integrating single-item PROMs into clinical settings. Importantly, it highlights how PROMs may perform differently across languages and contexts. More critical work is needed to understand if discrepancies between PROMs and CROMs are indicative of poor validity of PROMs or “valid” differences between patient and clinician perceptions.