Giordano Giulia Maria, Palumbo Davide, Pontillo Maria, Mucci Armida, Galderisi Silvana, Vicari Stefano
Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy.
Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, IRCSS Bambino Gesù Children's Hospital of Rome, Rome, Italy.
Schizophr Bull Open. 2022 Mar 10;3(1):sgac025. doi: 10.1093/schizbullopen/sgac025. eCollection 2022 Jan.
Negative symptoms (NS) appear early in subjects at ultra-high risk (UHR) for psychosis and may increase the risk of conversion to psychotic disorders and poor outcome. Contrary to schizophrenia, there is no consensus on the conceptualization and factor structure of NS in UHR subjects. This study aims to explore NS prevalence, factor structure, and impact on the outcome of UHR state in children and adolescents.
71 UHR were recruited at the Neuropsychiatry Unit of the Hospital Bambino Gesù in Rome. We examined the prevalence of NS of at least moderate severity, the factor structure of NS by Principal Component Analysis (PCA) and Confirmatory Factor Analysis (CFA), and correlations between extracted factors and functioning. We also evaluated the severity of baseline NS in subjects who converted to psychosis (converters) and in those who did not convert (nonconverters) at 1-year follow-up.
At baseline, all participants showed at least one NS of at least moderate severity. PCA and CFA yielded a two-factor solution: an ''Expressive" and an "Experiential" factor. Only the Experiential factor was associated with functioning. At baseline, severity of NS did not differ between converters ( = 16) and nonconverters ( = 55).
In UHR children and adolescents NS have a high prevalence, a significant impact on functioning, and cluster in two-factors. Replications by independent studies, with state-of-the-art instruments and longer duration of follow-up, are needed to improve the characterization of NS in this population, clarify their impact on the outcome and enhance their early identification, prevention, and treatment.
阴性症状（NS）在超高风险（UHR）精神病患者中出现较早，可能会增加转化为精神障碍和预后不良的风险。与精神分裂症不同，对于UHR患者中NS的概念化和因素结构尚无共识。本研究旨在探讨儿童和青少年中NS的患病率、因素结构及其对UHR状态结局的影响。
在罗马的 Bambino Gesù 医院神经精神病科招募了71名UHR患者。我们检查了至少中度严重程度的NS的患病率，通过主成分分析（PCA）和验证性因素分析（CFA）确定NS的因素结构，以及提取的因素与功能之间的相关性。我们还评估了在1年随访时转化为精神病的患者（转化者）和未转化的患者（未转化者）的基线NS严重程度。
在基线时，所有参与者至少表现出一种至少中度严重程度的NS。PCA和CFA得出了一个双因素解决方案：一个“表达性”因素和一个“体验性”因素。只有体验性因素与功能相关。在基线时，转化者（n = 16）和未转化者（n = 55）之间的NS严重程度没有差异。
在UHR儿童和青少年中，NS患病率高，对功能有重大影响，并聚类为两个因素。需要通过独立研究，使用先进的工具并延长随访时间进行重复研究，以改善对该人群中NS的特征描述，阐明它们对结局的影响，并加强其早期识别、预防和治疗。
