Miranda Bridgwater1, Peter Bachman2, Brenden Tervo-Clemmens3, Gretchen Haas2,3,4, Rebecca Hayes2, Beatriz Luna2,3,5, Dean F Salisbury2, Maria Jalbrzikowski2. 1. Department of Psychology, University of Maryland, Baltimore County, Maryland, USA. 2. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 3. Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA. 4. VISN4 MIRECC at VA Pittsburgh Healthcare System, Pittsburgh, PA, USA. 5. Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, USA.
Abstract
BACKGROUND: The neurodevelopmental model of psychosis was established over 30 years ago; however, the developmental influence on psychotic symptom expression - how age affects clinical presentation in first-episode psychosis - has not been thoroughly investigated. METHODS: Using generalized additive modeling, which allows for linear and non-linear functional forms of age-related change, we leveraged symptom data from a large sample of antipsychotic-naïve individuals with first-episode psychosis (N = 340, 12-40 years, 1-12 visits), collected at the University of Pittsburgh from 1990 to 2017. We examined relationships between age and severity of perceptual and non-perceptual positive symptoms and negative symptoms. We tested for age-associated effects on change in positive or negative symptom severity following baseline assessment and explored the time-varying relationship between perceptual and non-perceptual positive symptoms across adolescent development. RESULTS: Perceptual positive symptom severity significantly decreased with increasing age (F = 7.0, p = 0.0007; q = 0.003) while non-perceptual positive symptom severity increased with age (F = 4.1, p = 0.01, q = 0.02). Anhedonia severity increased with increasing age (F = 6.7, p = 0.00035; q = 0.0003), while flat affect decreased in severity with increased age (F = 9.8, p = 0.002; q = 0.006). Findings remained significant when parental SES, IQ, and illness duration were included as covariates. There were no developmental effects on change in positive or negative symptom severity (all p > 0.25). Beginning at age 18, there was a statistically significant association between severity of non-perceptual and perceptual symptoms. This relationship increased in strength throughout adulthood. CONCLUSIONS: These findings suggest that as maturation proceeds, perceptual symptoms attenuate while non-perceptual symptoms are enhanced. Findings underscore how pathological brain-behavior relationships vary as a function of development.
BACKGROUND: The neurodevelopmental model of psychosis was established over 30 years ago; however, the developmental influence on psychotic symptom expression - how age affects clinical presentation in first-episode psychosis - has not been thoroughly investigated. METHODS: Using generalized additive modeling, which allows for linear and non-linear functional forms of age-related change, we leveraged symptom data from a large sample of antipsychotic-naïve individuals with first-episode psychosis (N = 340, 12-40 years, 1-12 visits), collected at the University of Pittsburgh from 1990 to 2017. We examined relationships between age and severity of perceptual and non-perceptual positive symptoms and negative symptoms. We tested for age-associated effects on change in positive or negative symptom severity following baseline assessment and explored the time-varying relationship between perceptual and non-perceptual positive symptoms across adolescent development. RESULTS: Perceptual positive symptom severity significantly decreased with increasing age (F = 7.0, p = 0.0007; q = 0.003) while non-perceptual positive symptom severity increased with age (F = 4.1, p = 0.01, q = 0.02). Anhedonia severity increased with increasing age (F = 6.7, p = 0.00035; q = 0.0003), while flat affect decreased in severity with increased age (F = 9.8, p = 0.002; q = 0.006). Findings remained significant when parental SES, IQ, and illness duration were included as covariates. There were no developmental effects on change in positive or negative symptom severity (all p > 0.25). Beginning at age 18, there was a statistically significant association between severity of non-perceptual and perceptual symptoms. This relationship increased in strength throughout adulthood. CONCLUSIONS: These findings suggest that as maturation proceeds, perceptual symptoms attenuate while non-perceptual symptoms are enhanced. Findings underscore how pathological brain-behavior relationships vary as a function of development.
Entities:
Keywords:
Adolescence; age effects; antipsychotic-naïve; psychotic symptoms; schizophrenia
Authors: Philip R Corlett; Guillermo Horga; Paul C Fletcher; Ben Alderson-Day; Katharina Schmack; Albert R Powers Journal: Trends Cogn Sci Date: 2018-12-21 Impact factor: 20.229
Authors: Daniel Fulford; Tara A Niendam; Erin G Floyd; Cameron S Carter; Daniel H Mathalon; Sophia Vinogradov; Barbara K Stuart; Rachel L Loewy Journal: Schizophr Res Date: 2013-04-12 Impact factor: 4.939
Authors: I Joa; J O Johannessen; J Langeveld; S Friis; I Melle; S Opjordsmoen; E Simonsen; P Vaglum; T McGlashan; T K Larsen Journal: Acta Psychiatr Scand Date: 2009-02-05 Impact factor: 6.392
Authors: Maria Jalbrzikowski; Amy Lin; Ariana Vajdi; Vardui Grigoryan; Leila Kushan; Christopher R K Ching; Charles Schleifer; Rebecca A Hayes; Stephanie A Chu; Catherine A Sugar; Jennifer K Forsyth; Carrie E Bearden Journal: Mol Psychiatry Date: 2022-07-27 Impact factor: 13.437
Authors: Koen Bolhuis; Ulla Lång; David Gyllenberg; Antti Kääriälä; Juha Veijola; Mika Gissler; Ian Kelleher Journal: Schizophr Bull Date: 2021-10-21 Impact factor: 9.306