Apathy, poor verbal memory and male gender predict lower psychosocial functioning one year after the first treatment of psychosis

Abstract

Background Apathy is a negative symptom associated with poor psychosocial functioning in schizophrenia but has not been sufficiently studied as predictor of poor functioning in first episode psychosis (FEP). Objective The main aim of the current study was to evaluate if apathy predicts poor functioning after 1 year in FEP patients in the context of other clinical variables with influence on outcome. Method Sixty-four FEP patients completed an extensive clinical and neuro-psychological test battery at baseline and 1-year follow-up. Symptoms were assessed with the Positive and Negative Syndrome scale (PANSS), apathy with the shortened Apathy Evaluation Scale (AES-C-12) and psychosocial functioning with the functioning score from the split version of the Global Assessment of Functioning scale (GAF-F). Results High levels of apathy, poor verbal memory and being male were the baseline variables that best predicted poor functioning at 1-year follow-up, explaining 34% of the variance in GAF-F. When PANSS negative factor was included in the analysis, the significance of AES-C-12 diminished. Conclusion These findings points to a robust role for apathy among the negative symptoms in the development of persisting psychosocial dysfunction in FEP and supports the current effort in targeting motivation to improve functioning.

Predictors of functioning in people suffering from first‐episode psychosis 1 year into entering early intervention service in Hong Kong

“…In fact, various other trials exploring the predictive effects of psychopathology on functioning 4,5,8,13,20,24 yielded similar ranges of variances from 21.0% to 39.4%. The relatively small explained variance in this study might be due to the fact that cognitive abilities, one of the well-established predictors of functioning, 5,10,12,19,20 were not assessed. Moreover, as functioning is a 'real-world' construct, it can easily be affected by various environmental and societal factors.…”

“…8 Many studies argued that a longer duration of untreated psychosis was indicative of poorer functional outcomes, 7,13,14 yet negative studies existed. 10,15 While more severe positive, negative, depressive and cognitive symptoms were all indicative of poorer functional status, 2,4,5,7,12,13,[16][17][18][19][20] early symptomatic remission and functional recovery at 6-12 months after initiation of treatment appeared to be more predictive of longerterm functional outcomes. 6,9,[21][22][23][24] The early intervention service in Hong Kong was established in 2001, and was named EASY, that is, Early Assessment Service for Young people with early psychosis.…”

The use of clinical and biological characteristics to predict outcome following First Episode Psychosis

“…Impairment in verbal memory predicts persistent negative symptoms and functional outcomes (Faerden et al, 2013;Hovington et al, 2013).…”

Working Memory Deficit as a Risk Factor for Severe Apathy in Schizophrenia: A 1-Year Longitudinal Study

“…[3][4][5] Apathy, considered as a core component of negative symptoms 6,7 can be defined as a quantitative reduction of voluntary goal-directed behaviors, 8 and outside the schizophrenia literature has been the subject of fundamental research interest in neurological disorders such as Parkinson disease, brain injury and Alzheimer Disease. 1,9 In spite of the strong negative impact of apathy related symptoms in schizophrenia, 7 treatment studies for this frequent behavioral condition have provided limited evidence of efficiency.…”