Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, DK-2900 Hellerup, Denmark; Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, DK-2600 Glostrup, Denmark.
Copenhagen Research Centre for Mental Health (CORE), Copenhagen University Hospital, DK-2900 Hellerup, Denmark; Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, DK-2600 Glostrup, Denmark.
Schizophr Res. 2020 Apr;218:151-156. doi: 10.1016/j.schres.2020.01.012. Epub 2020 Jan 21.
Negative symptoms are key features of psychosis-spectrum disorders linked to psychosis development and functional impairments. This study investigated the predictive strength of negative symptoms domains on multiple aspects of real-life functional outcome in individuals at clinical high-risk (CHR) for psychosis.
A total of 146 UHR individuals were enrolled in a randomized, clinical trial (RCT), with this being analyses secondary to the RCT. The participants were assessed at baseline with the Scale for the Assessment of Negative Symptoms (SANS) encompassing the four domains of affect, alogia, avolition, and anhedonia. Functioning measures, encompassing overall-, social-, and role functioning, self-report social functioning, and quality of life, were obtained at 12-month follow-up. Regression analyses elucidated on the relationship between the four negative symptom domains and functional outcomes.
Anhedonia and avolition were the aspects of negative symptoms most predictive of real-life functioning at 12-month follow-up explaining 7-20% of the variance on the outcome measures. Alogia was predictive of social functioning. These findings were maintained when controlling for the effect of neurocognition, antipsychotic medication, and depressive symptoms.
Our findings show experiential negative symptoms to predict multiple areas of real-life functioning and quality of life, while expressive negative symptoms exert a modest influence on the functional prognosis of CHR individuals. Experiential negative symptoms may therefore constitute an important treatment target in intervention approaches aimed at enhancing the functional outcome of CHR individuals.
阴性症状是与精神病发展和功能障碍相关的精神病谱障碍的主要特征。本研究调查了阴性症状领域对处于精神病高危状态（CHR）的个体在多个现实生活功能结局方面的预测强度。
共有 146 名 UHR 个体参与了一项随机临床试验（RCT），这是对 RCT 的二次分析。参与者在基线时接受了阴性症状评定量表（SANS）的评估，该量表包括情感、言语贫乏、意志减退和快感缺失四个领域。在 12 个月的随访中，获得了功能测量结果，包括总体功能、社会功能和角色功能、自我报告的社会功能和生活质量。回归分析阐明了四个阴性症状领域与功能结局之间的关系。
快感缺失和意志减退是阴性症状中对 12 个月随访时现实生活功能最具预测性的方面，可解释结局测量的 7-20%的变异。言语贫乏可预测社会功能。当控制神经认知、抗精神病药物和抑郁症状的影响时，这些发现仍然成立。
我们的发现表明，体验性阴性症状可预测多个现实生活功能和生活质量领域，而表达性阴性症状对 CHR 个体的功能预后仅有适度影响。因此，体验性阴性症状可能构成干预方法中增强 CHR 个体功能结局的重要治疗目标。
