Impaired Social and Role Function in Ultra-High Risk for Psychosis and First-Episode Schizophrenia: Its Relations with Negative Symptoms

Abstract

ObjectivePsychosocial dysfunction was a nettlesome of schizophrenia even in their prodromal phase as well as first episode and its relations with psychopathology were not determined. The aim of the present study was to examine whether the social and role function impairment was found in ultra-high risk for psychosis (UHR) individuals as well as first-episode schizophrenia patients and to explore its relations with psychopathology.MethodsThirty-seven normal controls, 63 UHR participants and 28 young, first-episode schizophrenia patients were recruited. Psychosocial functioning was examined by using Global function: Social and Role scale. Psychopathologies of positive, negative and depressive symptom were also measured.ResultsSocial and role functioning in UHR were compromised at the equivalent level of those of first-episode schizophrenia patients. Multiple linear regression analysis revealed that social and role dysfunction was associated with negative symptoms in each UHR and first-episode schizophrenia group.ConclusionThese findings suggest that the significant impairment of social and role function may be appeared before the active psychosis onset at the level of extent to those of first-episode schizophrenia patients. The psychosocial intervention strategy especially targeting the negative symptoms should be developed and provided to individuals from their prepsychotic stage of schizophrenia.

Depressive psychopathology in first-episode schizophrenia spectrum disorders: a systematic review, meta-analysis and meta-regression

“…Thirty-five studies comprising 3180 participants examined the severity of depressive symptoms (Binder et al ., 1998; Zalsman et al ., 2003; Kampman et al ., 2004; Bendall et al ., 2008; Arranz et al ., 2009; Chen et al ., 2009; Strous et al , 2006; Strous et al ., 2009; Barrett et al ., 2010; Cotton et al ., 2010; Roche et al ., 2010; Upthegrove et al ., 2010; Chang et al ., 2011; Pena et al ., 2011; Shoval et al ., 2011; Riedel et al ., 2012; Stowkowy et al ., 2012; Zhao et al ., 2012; Allott et al ., 2013; Tosato et al ., 2013; Arrasate et al ., 2014; Chang et al ., 2014; Stouten et al ., 2014; Chang et al ., 2015; Emsley et al ., 2015; Noto et al ., 2015; Ruggeri et al ., 2015; Sanchez-Gistau et al ., 2015; Ebdrup et al ., 2016; Garcia et al ., 2016; Pawelczyk et al ., 2016; Chang et al ., 2017; Herniman et al ., 2017; Lee et al ., 2017; Zabala et al ., 2017). Three studies reported statistics by sub-group (Binder et al ., 1998; Tosato et al ., 2013; Pawelczyk et al ., 2016), totalling 38 samples.…”

EPA guidance on assessment of negative symptoms in schizophrenia

“…Additionally, persistent negative symptoms of a moderate to high severity level are present in a subgroup of CHR individuals [204,207]. Abundant evidence shows negative symptoms to be robustly associated with profound functional impairments in CHR individuals [208][209][210][211][212][213][214][215][216] as well as a predictor of transition to psychosis [204,207,211,217]. This key role of negative symptoms in CHR states is also recognized in the proposal to include negative symptoms to define and enroll CHR samples [218].…”

Heterogeneous trajectories in schizophrenia: insights from neurodevelopment and neuroprogression models

“…54 One possible marker of this change in development would be intellectual functioning, which can be reduced in these patients. 55,56 General cognition is impaired in individuals who later develop SZ even before the FEP, [57][58][59] resulting in consistent IQ deficits. 60,61 A previous study 55 and metaanalysis 62 found that the risk of developing SZ increases approximately 3.8% per 1-point decrease in IQ.…”