D J Devoe1, L Lu1, T D Cannon2, K S Cadenhead3, B A Cornblatt4, T H McGlashan5, D O Perkins6, L J Seidman7, M T Tsuang8, S W Woods5, E F Walker9, D H Mathalon10, C E Bearden11, J Addington12. 1. Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada. 2. Department of Psychology, Yale University, New Haven, CT, United States. 3. Department of Psychiatry, University of California San Diego, La Jolla, CA, United States. 4. Department of Psychiatry, Zucker Hillside Hospital, Queens, NY, United States. 5. Department of Psychiatry, Yale University, New Haven, CT, United States. 6. Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States. 7. Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States. 8. Department of Psychiatry, University of California San Diego, La Jolla, CA, United States; Institute of Genomic Medicine, University of California, La Jolla, CA, United States. 9. Department of Psychology, Emory University, Atlanta, GA, United States. 10. Department of Psychiatry, University of California, San Francisco, San Francisco, United States; Psychiatry Service, San Francisco, CA, United States. 11. Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, United States; Department Biobehavioral Sciences and Psychology, University of California, Los Angeles, Los Angeles, CA, United States. 12. Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada. Electronic address: jmadding@ucalgary.ca.
Abstract
BACKGROUND: Severity of negative symptoms has been associated with poor functioning, cognitive deficits, and defeatist beliefs in schizophrenia patients. However, one area that remains understudied is persistent negative symptoms (PNS). Negative symptoms, including PNS, have been observed in those at clinical high-risk (CHR) for psychosis. The aim of this study was to determine if PNS were associated with functioning, neurocognition, and defeatist beliefs in a CHR sample. METHOD: CHR participants (n = 764) were recruited for the North American Prodrome Longitudinal Study. Negative symptoms were rated on the Scale of Psychosis-risk Symptoms. Generalized linear mixed models for repeated measures were used to examine changes over time between and within groups (PNS vs non-PNS). RESULTS: The PNS group (n = 67) had significant deficits in functioning at baseline, 6, 12, 18, and 24-months compared to the non-PNS group (n = 673). Functioning improved over time in the non-PNS group, while functioning in the PNS group remained relatively stable and poor over a two-year period. A consistent trend emerged demonstrating higher defeatist beliefs in the PNS group; however, this result was lost when controlling for persistent depressive symptoms. There were no significant differences between the groups on neurocognition, social cognition, and transition to psychosis. CONCLUSIONS: PNS exist in youth at CHR for psychosis, resulting in significant and persistent functional impairment, which remains when controlling for persistent depressive symptoms. PNS remain even in CHR youth who do not transition to psychosis. Thus, PNS may represent an unmet therapeutic need in CHR populations for which there are currently no effective treatments.
BACKGROUND: Severity of negative symptoms has been associated with poor functioning, cognitive deficits, and defeatist beliefs in schizophrenia patients. However, one area that remains understudied is persistent negative symptoms (PNS). Negative symptoms, including PNS, have been observed in those at clinical high-risk (CHR) for psychosis. The aim of this study was to determine if PNS were associated with functioning, neurocognition, and defeatist beliefs in a CHR sample. METHOD: CHR participants (n = 764) were recruited for the North American Prodrome Longitudinal Study. Negative symptoms were rated on the Scale of Psychosis-risk Symptoms. Generalized linear mixed models for repeated measures were used to examine changes over time between and within groups (PNS vs non-PNS). RESULTS: The PNS group (n = 67) had significant deficits in functioning at baseline, 6, 12, 18, and 24-months compared to the non-PNS group (n = 673). Functioning improved over time in the non-PNS group, while functioning in the PNS group remained relatively stable and poor over a two-year period. A consistent trend emerged demonstrating higher defeatist beliefs in the PNS group; however, this result was lost when controlling for persistent depressive symptoms. There were no significant differences between the groups on neurocognition, social cognition, and transition to psychosis. CONCLUSIONS: PNS exist in youth at CHR for psychosis, resulting in significant and persistent functional impairment, which remains when controlling for persistent depressive symptoms. PNS remain even in CHR youth who do not transition to psychosis. Thus, PNS may represent an unmet therapeutic need in CHR populations for which there are currently no effective treatments.
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