Duration of attenuated positive and negative symptoms in individuals at clinical high risk: Associations with risk of conversion to psychosis and functional outcome

Abstract

Research in individuals at clinical high-risk (CHR) for psychosis has focused on subjects with no more than 12 months of present or worsened attenuated positive symptoms. However, the impact of long duration attenuated positive and/or negative prodromal symptoms on outcomes is unclear. Seventy-six CHR subjects with attenuated positive symptoms and at least moderate severity level negative symptoms rated on the Scale of Prodromal Symptoms (SOPS) were prospectively followed for a mean of 3.0 ± 1.6 years. Social and Role functioning was assessed with the Global Functioning: Social and Role scales. Correlations between attenuated positive and negative symptom duration and severity and conversion to psychosis and functional outcomes were analyzed. The average onset of SOPS rated negative symptoms (M = 53.24 months, SD = 48.90, median = 37.27) was approximately twelve months prior to the emergence of attenuated positive symptom (M = 40.15 months, SD = 40.33, median = 24.77, P < 0.05). More severe positive symptoms (P = 0.004), but not longer duration of positive (P = 0.412) or negative (P = 0.754) symptoms, predicted conversion to psychosis. Neither positive symptom duration (P = 0.181) nor severity (P = 0.469) predicted role or social functioning at study endpoint. Conversely, longer negative symptom duration predicted poor social functioning (P = 0.004). Overall, our findings suggest that the severity of attenuated positive symptoms at baseline may be more important than symptom duration for determining individuals at increased risk of developing psychosis. In contrast, long-standing negative symptoms may be associated with persistent social difficulties and therefore have an important position in the treatment of disability.

Characterization of children and adolescents with psychosis risk syndrome: The Children and Adolescents Psychosis Risk Syndrome (CAPRIS) study

“…In child and adolescent PRS samples, negative symptoms are of special interest as child and adolescent onset psychosis has a more insidious presentation with higher rates of negative symptoms (Ballageer, Malla, Manchanda, Takhar, & Haricharan, 2005) and is related to worse outcome (Fleischhaker et al, 2005). ANS in PRS child and adolescent samples appears months before APS and is associated with long-term social difficulties (Carrión et al, 2016). As this is a naturalistic study, we wanted to see whether a group of patients would meet ANS inclusion criteria only, and observe the prevalence of these criteria in a help-seeking sample of PRS.…”

The relationship between negative symptoms and cognitive functioning in patients at clinical high risk for psychosis

“…Negative symptoms are already present in ARMS patients and patients with a first-episode psychosis (FEP) and several studies highlighted their importance regarding the outcome of these patient groups. More severe negative symptoms are related to poorer social and role functioning in ARMS (Carrión et al, 2016;Cotter et al, 2014) and FEP patients (Diaz-Caneja et al, 2015), and negative symptoms represent significant predictors for conversion to psychosis Piskulic et al, 2012;Riecher-Rössler et al, 2009;Valmaggia et al, 2013).…”

Negative symptoms in the clinical high‐risk state for psychosis: Connection with cognition and primacy in impacting functioning

“…Niendam et al (2007) found that changes in visual memory and processing speed are associated with improvements in the GF:S over time. Carrión et al (2016)) and Schlosser et al (2015) found that negative symptoms predicted scores on the GF:S.…”