Trajectories of positive, negative and general psychopathology symptoms in first episode psychosis and their relationship with functioning over a 2-year follow-up period

Abdin, Edimansyah; Chong, Siow Ann; Vaingankar, Janhavi Ajit; Peh, Chao Xu; Poon, Lye Yin; Rao, Sujatha; Verma, Swapna; Subramaniam, Mythily

doi:10.1371/journal.pone.0187141

Cited by 41 publications

(35 citation statements)

References 31 publications

(68 reference statements)

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“…Distinguishing heterogeneous patients to more homogeneous subgroups is expedient not only to unveil common etiologies, but also at practical level to examine the patterns of clinical symptoms, understand the inherent course of the disease, predict treatment response and develop new treatment strategies specific to that subgroup to improve recovery and functional outcomes ( Figure 1). 29,30,33,34…”

Section: Heterogeneity In Schizophreniamentioning

confidence: 99%

“…Of the total of 17 longitudinal studies (Table 1), conducted in more than eight countries, 11 studies 31,33,34,36,[68][69][70][71][72][73][74] investigated the trajectory of both positive and negative positive symptoms in patients, three studies [75][76][77] the trajectory of only negative symptoms in patients, one study 78 the trajectory of schizotypy, and two studies 30,64 examined the trajectory of neurocognitive impairment in patients and siblings. The duration of follow-up ranged from six weeks to 10 years and included all population age groups.…”

Section: Symptomatic Trajectoriesmentioning

confidence: 99%

“…Additionally, five studies reported the influence of trajectories on long-term social, occupational and global functioning, and health-related or general quality of life. 34,73,[75][76][77] Even though all studies had similar aims, they used slightly different methods of trajectory analysis, such as growth mixture modelling (GMM) 31,69,74 , latent class growth analysis (LCGA) 30,33,34,70,73,76,77 , mixed mode latent class regression modelling 36,68,72 and group-based trajectory modelling (GBTM). 64 all studies except for one study 30 that reported deviance information criterion (DIC).…”

Section: Symptomatic Trajectoriesmentioning

confidence: 99%

“…As shown in Table 1, five studies 33,36,69,71,72 discovered five trajectories, three studies 31,68,74 identified three trajectories, and two studies 34,73 found two trajectories of positive symptoms. Similarly for the negative symptom dimension, four studies 36,69,71,72 discovered five trajectories, five studies 31,33,34,74,77 reported four trajectories, one study 76 depicted three trajectories and one study 73 found two trajectories. In addition, a study 75 from our research group identified four trajectories of negative symptom subdomains of social amotivation and expressive deficits.…”

Section: Page 12 Of 45mentioning

confidence: 99%

“…)31,33,34,36,[68][69][70][71][72][73][74][75][76][77] , the most common identified predictors of severe positive and/or negative symptoms trajectories were older age, male gender, ethnic minority, late age of illness onset, diagnosis of schizophrenia, long duration of untreated psychosis, long duration of illness, poor premorbid, global functioning, and quality of life, low cognitive performance, and severe baseline positive and negative symptoms.…”

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confidence: 98%

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Implications of data-driven analyses for personalized therapy in psychosis: a systematic review of cluster- and trajectory-based modelling studies

Rodijk

Liemburg

Sidorenkov

et al. 2019

Preprint

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= 244 words Text body = 4,558 words Abstract Introduction: To tackle the phenotypic heterogeneity of schizophrenia, data-driven methods are often applied to identify subtypes of its (sub)clinical symptoms though there is no systematic review. Aims: To summarize the evidence from cluster-and trajectory-based studies of positive, negative and cognitive symptoms in patients with schizophrenia spectrum disorders, their siblings and healthy people. Additionally, we aimed to highlight knowledge gaps and point out future directions to optimize the translatability of cluster-and trajectory-based studies. Methods: A systematic review was performed through searching PsycINFO, PubMed, PsycTESTS, PsycARTICLES, SCOPUS, EMBASE, and Web of Science electronic databases. Both cross-sectional and longitudinal studies published from 2008 to 2019, which reported at least two statistically derived clusters or trajectories were included. Two reviewers independently screened and extracted the data.Results: Of 2,285 studies retrieved, 50 studies (17 longitudinal and 33 cross-sectional) conducted in 30 countries were selected for review. Longitudinal studies discovered two to five trajectories of positive and negative symptoms in patient, and four to five trajectories of cognitive deficits in patient and sibling. In cross-sectional studies, three clusters of positive and negative symptoms in patient, four clusters of positive and negative schizotypy in sibling, and three to five clusters of cognitive deficits in patient and sibling were identified. These studies also reported multidimensional predictors of clusters and trajectories. Conclusions:Our findings indicate that (sub)clinical symptoms of schizophrenia are more heterogeneous than currently recognized. Identified clusters and trajectories can be used as a basis for personalized psychiatry.

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Section: Heterogeneity In Schizophreniamentioning

confidence: 99%

Section: Symptomatic Trajectoriesmentioning

confidence: 99%

Section: Symptomatic Trajectoriesmentioning

confidence: 99%

Section: Page 12 Of 45mentioning

confidence: 99%

mentioning

confidence: 98%

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Implications of data-driven analyses for personalized therapy in psychosis: a systematic review of cluster- and trajectory-based modelling studies

Rodijk

Liemburg

Sidorenkov

et al. 2019

Preprint

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The evolution of depression in first‐episode psychosis: A naturalistic database study

Basu

Verma

Abdin

2020

Clin Psychology and Psychoth

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Depression is commonly seen in the course of schizophrenia and can occur during any of the phases of the psychotic illness. The present study examines the incidence of depression at baseline and de novo depression in first episode of nonaffective psychoses and the course of depression in the 12 months following first‐episode psychosis, any predictive significance of baseline depression with recurrence of depression in the subsequent phases of the psychotic illness. The study was conducted with a clinical sample of 460 patients under the care of a first‐episode psychosis programme, and data relating to duration of untreated psychosis, sociodemographic data, Positive and Negative Symptom Scale (PANSS), Global Assessment of Functioning (GAF), and Clinical Global Impression (CGI) were collected. Diagnosis was made by at least two psychiatrists using SCID‐1, and depression was measured by Patient Health Questionnaire (PHQ‐9). Statistical analysis was performed using SAS version 9. We performed multiple logistic regression analyses to identify the sociodemographic and clinical factors that were associated with depression. Statistical significance was set at p value less than 0.05. We found that baseline depression was present in 34.42% patients with a preponderance of females (p = 0.047) and in those with secondary education. A suicide attempt is a strong predictor for depression at baseline. There was lower incidence of depression in those diagnosed with brief psychotic disorder (p = 0.015) and those with lower PANSS positive scores (p = 0.017). De novo depression over 12 months was 9.44%. Depression at 1‐year follow‐up was significantly predicted by depression at baseline.

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20‐year trajectories of positive and negative symptoms after the first psychotic episode in patients with schizophrenia spectrum disorder: results from the OPUS study

Starzer,

Hansen,

Hjorthøj

et al. 2023

World Psychiatry

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This study aimed to identify the 20‐year trajectories of positive and negative symptoms after the first psychotic episode in a sample of patients with an ICD‐10 diagnosis of schizophrenia spectrum disorder, and to investigate the baseline characteristics and long‐term outcomes associated with these trajectories. A total of 373 participants in the OPUS trial were included in the study. Symptoms were assessed at baseline and after 1, 2, 5, 10 and 20 years using the Scales for the Assessment of Positive and Negative Symptoms. We used latent class growth mixture modelling to identify trajectories, and multinominal regression analyses to investigate predictors of membership to identified trajectories. Five trajectories of positive symptoms were identified: early continuous remission (50.9% of the sample), stable improvement (18.0%), intermittent symptoms (10.2%), relapse with moderate symptoms (11.9%), and continuous severe symptoms (9.1%). Substance use disorder (odds ratio, OR: 2.83, 95% CI: 1.09‐7.38, p=0.033), longer duration of untreated psychosis (OR: 1.02, 95% CI: 1.00‐1.03, p=0.007) and higher level of negative symptoms (OR: 1.60, 95% CI: 1.07‐2.39, p=0.021) were predictors of the relapse with moderate symptoms trajectory, while only longer duration of untreated psychosis (OR: 1.01, 95% CI: 1.00‐1.02, p=0.030) predicted membership to the continuous severe symptoms trajectory. Two trajectories of negative symptoms were identified: symptom remission (51.0%) and continuous symptoms (49.0%). Predictors of the continuous symptoms trajectory were male sex (OR: 3.03, 95% CI: 1.48‐6.02, p=0.002) and longer duration of untreated psychosis (OR: 1.01, 95% CI: 1.00‐1.02, p=0.034). Trajectories displaying continuous positive and negative symptoms were linked to lower neurocognition, as measured by the Brief Assessment of Cognition in Schizophrenia (BACS) (z‐score: –0.78, CI: –1.39 to –0.17, for continuous positive symptoms; z‐score: –0.33, CI: –0.53 to –0.13, for continuous negative symptoms). The same trajectories were also linked to higher use of antipsychotic medication at 20‐year follow‐up (continuous positive symptoms: 78%; continuous negative symptoms: 67%). These findings suggest that the majority of patients with first‐episode schizophrenia spectrum disorder have a trajectory with early stable remission of positive symptoms. Long duration of untreated psychosis and comorbid substance abuse are modifiable predictors of poor trajectories for positive symptoms in these patients. In about half of patients, negative symptoms do not improve over time. These symptoms, in addition to being associated with poor social and neurocognitive functioning, may prevent patients from seeking help.

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Trajectories of positive, negative and general psychopathology symptoms in first episode psychosis and their relationship with functioning over a 2-year follow-up period

Cited by 41 publications

References 31 publications

Implications of data-driven analyses for personalized therapy in psychosis: a systematic review of cluster- and trajectory-based modelling studies

Implications of data-driven analyses for personalized therapy in psychosis: a systematic review of cluster- and trajectory-based modelling studies

The evolution of depression in first‐episode psychosis: A naturalistic database study

20‐year trajectories of positive and negative symptoms after the first psychotic episode in patients with schizophrenia spectrum disorder: results from the OPUS study

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