Financial competence, situation, and context of people with recent-onset psychosis: A comparison with matched controls and the role of cognition

Objective: People with a psychotic disorder often experience financial challenges. Financial competence problems might underlie these challenges, yet little is known about the extent and type of these problems, particularly in the recent-onset phase of psychosis. This study aimed to examine differences in financial competence between people with recent-onset psychosis and matched controls without psychosis. In addition, we assessed participants’ financial situation and context. Last, we investigated cognitive functioning and its potential mediating role in group differences in financial competence.

Method: Thirty-six people with recent-onset psychosis and 40 matched controls completed a comprehensive and standardized financial and cognitive test battery.

Results: Compared to controls, people with recent-onset psychosis performed more poorly on most aspects of financial competence. They also reported less favorable outcomes in their financial situation and context. Mediation analyses did not support a robust mediating role of cognitive functioning in explaining group differences in financial competence.

Conclusions: Problems in financial competence, as well as a less favorable financial situation and context, may already be present in the recent-onset phases of psychosis. These difficulties appear to be multifaceted and cannot be explained by cognitive functioning. These findings highlight the need for assessment tools that go beyond cognitive assessment and are specifically designed to evaluate everyday competences such as financial competence. Integrating such assessments into clinical practice could support timely recognition of problems in financial competence and more appropriate, tailored referrals to financial support services for people in the recent-onset phases of psychosis.