Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-26T05:58:20.589Z Has data issue: false hasContentIssue false

Negative symptom subgroups have different effects on the clinical course of schizophrenia after the first episode: A 24-month follow up study

Published online by Cambridge University Press:  15 April 2020

Get access

Abstract

Objective:

The aim of this study was to assess the factor structure of negative symptoms in first-episode schizophrenia (FES), and to examine the relationship of these factors with clinical course and functioning of patients during the two-year follow up.

Method:

We assessed 174 drug-naïve patients with FES using Brief Psychiatric Rating Scale-Expanded (BPRS), Scale for the Assessment of Negative Symptoms (SANS), Scale for the Assessment of Positive Symptoms (SAPS), and Global Assessment of Functioning (GAF) and a cognitive battery at admission. The scales were repeated monthly during follow up. We recorded the patients’ functioning levels, remission, and work status after 12 and 24 months.

Results:

A two-factor structure was found at the baseline, whereas one factor was found after 12 and 24 months. Expressive deficit (ED) factor consisted of alogia and blunted affect, and motivation-pleasure deficit (MPD) factor consisted of avolition and anhedonia. ED factor was related to earlier onset and remission, and it was negatively correlated with duration of education and cognitive test scores. MPD factor was related to duration of untreated psychosis, family history of schizophrenia, and work status, and it appeared as the only independent variable that contributed to the baseline GAF score in linear regression analysis.

Conclusion:

Our findings suggest that the factors have different aetiologies and impacts on the clinical course of schizophrenia and functioning after FES.

Type
Original article
Copyright
Copyright © Elsevier Masson SAS 2015

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andreasen, NCScale for the Assessment of Negative Symptoms. Iowa City: University of Iowa Press; 1983.Google Scholar
Andreasen, NCScale for the Assessment of Positive Symptoms. Iowa City: University of Iowa Press; 1984.Google Scholar
Andreasen, NC, Carpenter, WT, Kane, JM, Lasser, RA, Marder, SR, Weinberger, DR. Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry 2005;162:441449.CrossRefGoogle ScholarPubMed
Bell, MD, Corbera, S, Johannesen, JK, Fiszdon, JM, Wexler, BE. Social cognitive impairments and negative symptoms in schizophrenia: are there subtypes with distinct functional correlates?. Schizophr Bull 2013;39:186196.CrossRefGoogle ScholarPubMed
Blanchard, JJ, Cohen, AS. The structure of negative symptoms within schizophrenia: implications for assessment. Schizophr Bull 2006;32:238245.CrossRefGoogle ScholarPubMed
Cannon-Spoor, HE, Potkin, SG, Wyatt, RJ. Measurement of premorbid adjustment in chronic schizophrenia. Schizophr Bull 1982;8:470484.CrossRefGoogle ScholarPubMed
Carpenter, WT, Heinrichs, DW, Wagman, M. Deficit and nondeficit forms of schizophrenia: the concept. Am J Psychiatry 1988;145:578583.Google ScholarPubMed
Díaz, I, Pelayo-Terán, JM, Pérez-Iglesias, R, Mata, I, Tabarés-Seisdedos, R, Suárez-Pinilla, P, et al.Predictors of clinical remission following a first episode of non-affective psychosis: sociodemographics, premorbid and clinical variables. Psychiatry Res 2013;206:181187.CrossRefGoogle ScholarPubMed
Esterberg, M, Compton, M. Family history of psychosis negatively impacts age at onset, negative symptoms, and duration of untreated illness and psychosis in first-episode psychosis patients. Psychiatry Res 2012;197:2328.CrossRefGoogle ScholarPubMed
Esterberg, ML, Trotman, HD, Holtzman, C, Compton, MT, Walker, EF. The impact of a family history of psychosis on age-at-onset and positive and negative symptoms of schizophrenia: a meta-analysis. Schizophr Res 2010;120:121130.CrossRefGoogle ScholarPubMed
Faerden, A, Finset, A, Friis, S, Agartz, I, Barrett, EA, Nesvåg, R, et al.Apathy in first episode psychosis patients: one year follow up. Schizophr Res 2010;116:2026.CrossRefGoogle ScholarPubMed
Fervaha, G, Foussias, G, Agid, O, Remington, G. Amotivation and functional outcomes in early schizophrenia. Psychiatry Res 2013;210:665668.CrossRefGoogle ScholarPubMed
First, MB, Spitzer, RL, Gibbon, M, Williams, JBWStructured Clinical Interview for DSM-IV Axis I disorders, Clinician Version. Washington, D.C.: American Psychiatric Press, Inc; 1997.Google Scholar
Foussias, G, Remington, G. Negative symptoms in schizophrenia: avolition and Occam's razor. Schizophr Bull 2010;36:359369.CrossRefGoogle ScholarPubMed
Gaebel, W, Riesbeck, M, Wölwer, W, Klimke, A, Eickhoff, M, von Wilmsdorff, M, et al.Rates and predictors of remission in first-episode schizophrenia within 1 year of antipsychotic maintenance treatment. Results of a randomized controlled trial within the German Research Network on Schizophrenia. Schizophr Res 2014;152:478486.CrossRefGoogle ScholarPubMed
Galderisi, S, Bucci, P, Mucci, A, Kirkpatrick, B, Pini, S, Rossi, A, et al.Categorical and dimensional approaches to negative symptoms of schizophrenia: focus on long-term stability and functional outcome. Schizophr Res 2013;147:157162.CrossRefGoogle ScholarPubMed
Galderisi, S, Mucci, A, Bitter, I, Libiger, J, Bucci, P, Wolfgang Fleischhacker, W, et al.Persistent negative symptoms in first episode patients with schizophrenia: results from the European First Episode Schizophrenia Trial. Eur Neuropsychopharmacol 2013;23:196204.CrossRefGoogle ScholarPubMed
Golden, CJThe Stroop Color and Word Test: a manual for clinical and experimental uses. Chicago: Stoelting Co; 1978.Google Scholar
González-Ortega, I, de los Mozos, V, Echeburúa, E, Mezo, M, Besga, A, Ruiz de Azúa, S, et al.Working memory as a predictor of negative symptoms and functional outcome in first episode psychosis. Psychiary Res. 2013;206:816.CrossRefGoogle ScholarPubMed
Green, MF, Penn, DL, Bentall, R, Carpenter, WT, Gaebel, W, Gur, RC, et al.Social cognition in schizophrenia: an NIMH workshop on definitions, assessment, and research opportunities. Schizophr Bull 2008;34:12111220.CrossRefGoogle ScholarPubMed
Heaton, RK, Chelune, GJ, Talley, JL, Kay, GG, Curtiss, GWisconsin Card Sorting Test manual: revised and expanded. Odessa: Psychological Assessment Resources; 1993.Google Scholar
Keefe, RS, Harvey, PD, Lenzenweger, MF, Davidson, M, Apter, SH, Schmeidler, J, et al.Empirical assessment of the factorial structure of clinical symptoms in schizophrenia: negative symptoms. Psychiatry Res 1992;44:153165.CrossRefGoogle ScholarPubMed
Kelley, ME, van Kammen, DP, Allen, DN. Empirical validation of primary negative symptoms: independence from effects of medication and psychosis. Am J Psychiatry 1999;156:406411.Google ScholarPubMed
Kimhy, D, Yale, S, Goetz, RR, McFarr, LM, Malaspina, D. The factorial structure of the schedule for the deficit syndrome in schizophrenia. Schizophr Bull 2006;32:274278.CrossRefGoogle Scholar
Kirchner, WK. Age differences in short-term retention of rapidly changing information. J Exp Psychol 1958;55:352358.CrossRefGoogle ScholarPubMed
Kirkpatrick, B, Fenton, WS, Carpenter, WT Jr., Marder, SR. The NIMH-MATRICS consensus statement on negative symptoms. Schizophr Bull 2006;32:214219.CrossRefGoogle ScholarPubMed
Kirkpatrick, B, Fischer, B. Subdomains within the negative symptoms of schizophrenia: commentary. Schizophr Bull 2006;32:246249.CrossRefGoogle ScholarPubMed
Lang, FU, Kösters, M, Lang, S, Becker, T, Jäger, M. Psychopathological long-term outcome of schizophrenia – a review. Acta Psychiatr Scand 2013;127:173182.CrossRefGoogle ScholarPubMed
Liemburg, E, Castelein, S, Stewart, R, van der Gaag, M, Aleman, A, Knegtering, H. Two subdomains of negative symptoms in psychotic disorders: established and confirmed in two large cohorts. J Psychiatr Res 2013;47:718725.CrossRefGoogle ScholarPubMed
Lin, CH, Huang, CL, Chang, YC, Chen, PW, Lin, CY, Tsai, GE, et al.Clinical symptoms, mainly negative symptoms, mediate the influence of neurocognition and social cognition on functional outcome of schizophrenia. Schizophr Res 2013;146:231237.CrossRefGoogle ScholarPubMed
Lukoff, D, Nuechterlein, KH, Ventura, J. Manual for the Expanded Brief Psychiatric Rating Scale. Schizophr Bull 1986;12:594602.Google Scholar
Malla, AK, Takhar, JJ, Norman, RMG, Manchanda, R, Cortese, L, Haricharan, R, et al.Negative symptoms in first episode non-affective psychosis. Acta Psychiatr Scand 2002;105:431439.CrossRefGoogle ScholarPubMed
Möller, HJ. Clinical evaluation of negative symptoms in schizophrenia. Eur Psychiatry 2007;22:380386.CrossRefGoogle Scholar
Mueser, KT, Sayers, SL, Schooler, NR, Mance, RM, Haas, GL. A multisite investigation of the reliability of the Scale for the Assessment of Negative Symptoms. Am J Psychiatry 1994;151:14531462.Google ScholarPubMed
Nakaya, M, Ohmori, K. A two-factor structure for the schedule for the deficit syndrome in schizophrenia. Psychiatry Res 2008;158:256259.CrossRefGoogle Scholar
Penn, DL, Sanna, LJ, Roberts, DL. Social cognition in schizophrenia: an overview. Schizophr Bull 2008;34:408411.CrossRefGoogle ScholarPubMed
Peralta, V, Cuesta, MJ. Negative symptoms in schizophrenia: a confirmatory factor analysis of competing models. Am J Psychiatry 1995;152:14501457.Google ScholarPubMed
Ramsay, CE, Stewart, T, Compton, MT. Unemployment among patients with newly diagnosed first-episode psychosis: prevalence and clinical correlates in a US sample. Soc Psychiatry Psychiatr Epidemiol 2012;47:797803.CrossRefGoogle Scholar
Reitan, RM. The relation of the trail making test to organic brain damage. J Consult Psychol 1955;19:393394.CrossRefGoogle ScholarPubMed
Rey, AThe clinical exam in psychology. Paris: Presses universitaires de France; 1964.Google Scholar
Rosvold, HE, Mirsky, AF, Sarason, I, Bransome, ED, Beck, LH. A continuous performance test of brain damage. J Consult Psychol 1956;20:343350.CrossRefGoogle Scholar
Simonsen, E, Friis, S, Opjordsmoen, S, Mortensen, EL, Haahr, U, Melle, I, et al.Early identification of non-remission in first-episode psychosis in a two-year outcome study. Acta Psychiatr Scand 2010;122:375383.CrossRefGoogle Scholar
Strauss, GP, Horan, WP, Kirkpatrick, B, Fischer, BA, Keller, WR, Miski, P, et al.Deconstructing negative symptoms of schizophrenia: avolition-apathy and diminished expression clusters predict clinical presentation and functional outcome. J Psychiatr Res 2013;47:783790.CrossRefGoogle ScholarPubMed
Turner, N, Browne, S, Clarke, M, Gervin, M, Larkin, C, Waddington, JL, et al.Employment status amongst those with psychosis at first presentation. Soc Psychiatry Psychiatr Epidemiol 2009;44:863869.CrossRefGoogle ScholarPubMed
Üçok, A, Direk, N, Koyuncu, A, Keskin-Ergen, Y, Yüksel, C, Güler, J, et al.Cognitive deficits in clinical and familial high risk groups for psychosis are common as in first episode schizophrenia. Schizophr Res 2013;151:265269.CrossRefGoogle ScholarPubMed
Ventura, J, Hellemann, GS, Thames, AD, Koellner, V, Nuechterlein, KH. Symptoms as mediators of the relationship between neurocognition and functional outcome in schizophrenia: a meta-analysis. Schizophr Res 2009;113:189199.CrossRefGoogle ScholarPubMed
Verma, S, Subramaniam, M, Abdin, E, Poon, LY, Chong, SA. Symptomatic and functional remission in patients with first-episode psychosis. Acta Psychiatr Scand 2012;126:282289.CrossRefGoogle ScholarPubMed
Wechsler, DWechsler adult intelligence scale-revised. New York; The Psychological Corporation; 1981.Google Scholar
Zimbrón, J, Ruiz de Azúa, S, Khandaker, GM, Gandamaneni, PK, Crane, CM, González-Pinto, A, et al.Clinical and sociodemographic comparison of people at high-risk for psychosis and with first-episode psychosis. Acta Psychiatr Scand 2013;127:210216.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.