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. 2021 Jan:227:28-37.
doi: 10.1016/j.schres.2020.04.004. Epub 2020 Apr 30.

Persistent negative symptoms in youth at clinical high risk for psychosis: A longitudinal study

D J Devoe  1 , L Lu  1 , T D Cannon  2 , K S Cadenhead  3 , B A Cornblatt  4 , T H McGlashan  5 , D O Perkins  6 , L J Seidman  7 , M T Tsuang  8 , S W Woods  5 , E F Walker  9 , D H Mathalon  10 , C E Bearden  11 , J Addington  12
Affiliations

Persistent negative symptoms in youth at clinical high risk for psychosis: A longitudinal study

D J Devoe et al. Schizophr Res. 2021 Jan.

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.

Keywords: Clinical high risk; Defeatist beliefs; Functioning; Negative-self schemas; Persistent negative symptoms; Psychosis.

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Conflict of interest statement

Declaration of competing interest The authors have declared that there are no conflicts of interest in relation to the subject of this study. Dr. Cannon and Dr. Mathalon report that they are consultants to Boerhinger Ingelheim Pharmaceuticals. Dr. Cannon reports that he is a consultant to Lundbeck A/S.

Figures

Figure 1.
Figure 1.
Flow Diagram
Figure 2.
Figure 2.
Differences between groups on Global Functioning: Role (GF:R) with 95% Confidence limits
Figure 3.
Figure 3.
Differences between groups on Global Functioning: Social (GF:S) with 95% Confidence limits
Figure 4.
Figure 4.
Differences between groups for Negative-Self Schemas
See this image and copyright information in PMC

References

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