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

• Type of Material: Article
• Authors: DJ Devoe, University of Calgary; L Lu, University of Calgary; TD Cannon, Yale University; KS Cadenhead, University of California San Diego; BA Cornblatt, Zucker Hillside Hospital, Queens; TH McGlashan, Yale University; DO Perkins, University of North Carolina; LJ Seidman, Harvard Medical School; MT Tsuang, University of California San Diego; SW Woods, Yale University; Elaine Walker, Emory University; DH Mathalon, University of California San Francisco; CE Bearden, University of California Los Angeles; J Addington, University of Calgary
• Language: English
• Date: 2021-01-29
• Publisher: ELSEVIER
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020 Elsevier B.V. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.schres.2020.04.004
• Title of Journal or Parent Work: SCHIZOPHRENIA RESEARCH
• Volume: 227
• Start Page: 28
• End Page: 37
• Grant/Funding Information: This study was supported by the National Institute of Mental Health (grant U01 MH081984 to Dr. Addington; grants U01 MH081928; P50 MH080272; Commonwealth of Massachusetts SCDMH82101008006 to Dr. Seidman; grants R01 MH60720, U01 MH082022 and K24 MH76191 to Dr. Cadenhead; grant U01 MH081902 to Dr. Cannon; P50 MH066286 (Prodromal Core), the Staglin Family Music Festival for Mental Health and the Joseph Levin Trust to Dr. Bearden; grant U01 MH082004 to Dr. Perkins; grant U01 MH081988 to Dr. Walker; grant U01 MH082022 to Dr. Woods; and U01 MH081857-05 grant to Dr. Cornblatt). Dan Devoe is funded by the Alberta Innovates Graduate Studentship.
• Keywords: Science & Technology; Defeatist beliefs; Psychosis; Functioning; Clinical high risk; Psychiatry; Negative-self schemas; Life Sciences & Biomedicine; Persistent negative symptoms

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.