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. 2015 Feb;161(2-3):407-13.
doi: 10.1016/j.schres.2014.10.043. Epub 2014 Dec 8.

Negative symptoms and functioning during the first year after a recent onset of schizophrenia and 8 years later

Joseph Ventura  1 , Kenneth L Subotnik  2 , Michael J Gitlin  2 , Denise Gretchen-Doorly  2 , Arielle Ered  2 , Kathleen F Villa  3 , Gerhard S Hellemann  2 , Keith H Nuechterlein  4
Affiliations

Negative symptoms and functioning during the first year after a recent onset of schizophrenia and 8 years later

Joseph Ventura et al. Schizophr Res. 2015 Feb.

Abstract

Background: Understanding the longitudinal course of negative symptoms, especially in relationship to functioning, in the early phase of schizophrenia is crucial to developing intervention approaches. The course of negative symptoms and daily functioning was examined over a 1-year period following a recent onset of schizophrenia and at an 8-year follow-up point.

Methods: The study included 149 recent-onset schizophrenia patients who had a mean age of 23.7 (SD=4.4)years and mean education of 12.9 (SD=2.2)years. Negative symptom (BPRS and SANS) and functional outcome (SCORS) assessments were conducted frequently by trained raters.

Results: After antipsychotic medication stabilization, negative symptoms during the first outpatient year were moderately stable (BPRS ICC=0.64 and SANS ICC=0.66). Despite this overall moderate stability, 24% of patients experienced at least one period of negative symptoms exacerbation. Furthermore, entry level of negative symptoms was significantly associated with poor social functioning (r=-.34, p<.01) and work/school functioning (r=-.25, p<.05) at 12months, and with negative symptoms at the 8-year follow-up (r=.29, p<.05).

Discussion: Early negative symptoms are fairly stable during the first outpatient year, are predictors of daily functioning at 12months, and predict negative symptoms 8years later. Despite the high levels of stability, negative symptoms did fluctuate in a subsample of patients. These findings suggest that negative symptoms may be an important early course target for intervention aimed at promoting recovery.

Keywords: BPRS; Functional outcome; Intraclass correlation coefficient; Long-term follow-up; Negative symptoms; SANS; Schizophrenia; Symptom exacerbation.

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Conflict of interest statement

Conflict of Interest

Joseph Ventura, Ph.D., has received funding from Janssen Scientific Affairs, LLC, Brain Plasticity, Inc., and Genentech, Inc. He has served as a consultant to Brain Plasticity, Inc., and Boehringer-Ingelheim, GmbH.

Kenneth L. Subotnik, Ph.D., has received research funding from Janssen Scientific Affairs, LLC, and Genentech, Inc., through grants to Drs. Nuechterlein and Ventura. He is a consultant to Otsuka America Pharmaceutical, Inc.

Michael J. Gitlin, M.D., has received funding from or been a consultant to Eli Lilly and Company, AstraZeneca, Bristol-Myers Squibb, and Otsuka America Pharmaceutical, Inc.

Kathleen F. Villa was an employee of Genentech, Inc. at the time that this work was completed and is now an employee of Jazz Pharmaceuticals, plc.

Denise Gretchen-Doorly, Ph.D., Gerhard S. Hellemann, Ph.D., and Arielle Ered., have no financial conflicts of interest to disclose.

Keith H. Nuechterlein, Ph.D., has received funding from Janssen Scientific Affairs, LLC, Brain Plasticity, Inc., and Genentech, Inc. He has served as a consultant to Genentech, Inc. and Otsuka America Pharmaceutical, Inc.

References

    1. Albert N, Bertelsen M, Thorup A, Petersen L, Jeppesen P, Le Quack P, Krarup G, Jørgensen P, Nordentoft M. Predictors of recovery from psychosis: Analyses of clinical and social factors associated with recovery among patients with first-episode psychosis after 5 years. Schizophrenia Research. 2011;125(2–3):257–266. - PubMed
    1. Andreasen NC. The Scale for the Assessment of Negative Symptoms (SANS) The University of Iowa; Iowa City, IA: 1984.
    1. Andreasen NC, Carpenter WT, Jr, Kane JM, Lasser RA, Marder SR, Weinberger DR. Remission in schizophrenia: proposed criteria and rationale for consensus. American Journal of Psychiatry. 2005;162(3):441. - PubMed
    1. Andreasen NC, Pressler M, Nopoulos P, Miller D, Ho BC. Antipsychotic dose equivalents and dose-years: a standardized method for comparing exposure to different drugs. Biological psychiatry. 2010;67(3):255–262. - PMC - PubMed
    1. Becker D, Drake R. A Working Life for People with Severe Mental Illness. Oxford Press; New York: 2003.

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