Negative symptom dimensions differentially impact on functioning in individuals at-risk for psychosis

Chang, Wing Chung; Lee, H C; Chan, Suet In; Chiu, Sau Ying; Lee, H M; Chan, Karen M. K.; Wong, Moses; Chan, Kwok Ling; Yeung, Wai-Song; Choy, Lam Wai; Chong, Shiu Yin; Siu, Man Wa; Lo, Tak Lam; Yan, Wai Ching; Ng, Man Kin; Poon, Lap Tak; Pang, Pui Fai; Wong, Yip Chau; Chung, Wai Sau; Mo, Yi Man Flora; Lui, Simon S.Y.; Hui, Christy Lai Ming; Chen, Eric

doi:10.1016/j.schres.2018.06.041

Cited by 10 publications

(6 citation statements)

References 56 publications

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“…Although not included in the aggregated meta-analyses, one study reported a significant relationship between avolition and global functioning (d, −1.71; 95% CI= −2.2, −1.21; r, −0.65; P<0.001, 1 study, N=110). 58…”

Section: Avolition and Functioningmentioning

confidence: 99%

Negative Symptoms and Functioning in Youth at Risk of Psychosis: A Systematic Review and Meta-analysis

Devoe

Braun

Seredynski

et al. 2020

Harv Rev Psychiatry

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Aim: Youth at clinical high risk for psychosis often demonstrate significant negative symptoms and poor functioning. However, the magnitude and direction of the relationship between the two remains unknown. Therefore, the objective of this systematic review was to summarize the relationship between negative symptoms and functioning in CHR samples.Method: Electronic databases Embase, EBM, MEDLINE, CINAHL, and PsycINFO were searched from inception. Studies were selected if they included any study that reported a relationship between negative symptoms and functioning in youth at CHR. The correlation coefficient r was converted to Cohen's d and all random effects meta-analyses were performed using the transformed values.Results: Forty-one studies met the inclusion criteria, including a total of 4,574 clinical high risk for psychosis individuals. Negative symptom total scores were significantly associated with poorer global functioning (d, −1.40; 95% CI= −1.82, −0.98; I 2 =79.4%; P<0.001, 9 studies, N=782), social functioning (d, −1.10; 95% CI= −1.27, −0.93; I 2 =10.40%; P<0.001, 12 studies, N=811), and role functioning (d, −0.96; 95% CI= −1.17, −0.76; I 2 =41.1%; P<0.001, 9 studies, N=881).In addition, negative symptoms were consistently associated with poor premorbid functioning. When examining negative symptom domains; avolition, anhedonia, and blunted affect were each significantly and independently associated with poorer social functioning and role functioning. In terms of prediction models, negative symptoms contributed to the prediction of lower functioning across multiple studies. Conclusion:This meta-analysis demonstrated a consistent and strong relationship between negative symptoms and functioning in youth at clinical high risk for psychosis.

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Section: Avolition and Functioningmentioning

confidence: 99%

Negative Symptoms and Functioning in Youth at Risk of Psychosis: A Systematic Review and Meta-analysis

Devoe

Braun

Seredynski

et al. 2020

Harv Rev Psychiatry

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“…and longer duration of negative symptoms (Carrión et al, 2016) were related to poor social functioning in UHR group whereas these results were not confirmed by other studies (Chang et al, 2018;Shim et al, 2008). In a recent study, persistent negative symptoms in UHR group were associated with poor psychosocial functioning at follow-up (Yung, Nelson, McGorry, Wood, & Lin, 2019).…”

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confidence: 61%

Relationship of negative symptom severity with cognitive symptoms and functioning in subjects at ultra‐high risk for psychosis

Üçok

Direk

Kaya

et al. 2020

Early Intervention Psych

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Aim: Negative symptoms and cognition are related with functioning in schizophrenia. However, it is not clear whether they have a similar effect in individuals at ultra-high risk (UHR) for psychosis. In this study, we aimed to explore relationship of negative symptoms with cognition and functioning cross-sectionally in people with UHR for psychosis.Methods: In total, 107 people participated in this study. We assessed negative symptoms with Scale for Negative Symptoms (SANS). We applied a cognitive battery including seven tests. We evaluated functioning by using Global Assessment of Functioning Scale and work/study status as an indicator of role functioning.Results: SANS scores were correlated to global functioning cross-sectionally. SANS total score was correlated to cognitive test scores related to cognitive flexibility and attention. Only Trail Making Test B (TMT B) was negatively correlated to global functioning. SANS-affective blunting and SANS-avolition scores were independently related to global functioning. There was a significant indirect effect of the TMT B and composite attention scores on global functioning through negative symptoms indicating a complete mediation. Conclusion:Our findings suggest that negative symptoms, particularly avolition have an impact on functioning and the association of cognition with functioning was mediated by negative symptoms in UHR.

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“…This is a naturalistic prospective study examining the longitudinal course of ARMS and prediction of psychosis transition in Hong Kong (Chang et al, 2018;Chang, Ng, et al, 2020;Chu et al, 2019) In total, 177 Chinese help-seeking participants aged 15-40 years were recruited between 1 January 2014 and 31 December 2018 from outpatient units of EASY (Early Assessment Service for Young people with psychosis). The EASY program is a territory-wide, publicly funded specialized early intervention service for first-episode psychosis in Hong Kong (Chung & Chen, 2013).…”

Section: Participants and Settingmentioning

confidence: 99%

“…Given that lack of normal distress item (single-item subscale) is not conceptually considered a negative symptom per se (Kirkpatrick et al, 2011) and previous research did not include this item to define negative symptom structure (e.g., , we thus focused on the other five BNSS subscales (which adhered to five consensus domains of negative symptoms; Kirkpatrick et al, 2006) for study analyses. To enhance the comprehensiveness and appropriateness of negative symptom assessment to ARMS individuals who are mostly in adolescence or early adulthood, additional probe questions were incorporated in BNSS to enquire for social media/digital social interactions (e.g., Facebook, texting via mobile phone) and living situations (e.g., living in dormitory with roommates) of young people (Chang et al, 2018;. Functional levels were measured by Global Functioning (GF): Social and Role Scales (Cornblatt et al, 2007) (Gold et al, 1997) and category verbal fluency.…”

Section: Assessmentsmentioning

confidence: 99%

Sex differences in symptom severity, cognition and psychosocial functioning among individuals with at‐risk mental state for psychosis

Chan

Chang

et al. 2021

Early Intervention Psych

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Aim: Sex differences are well documented in schizophrenia, but have been much less studied in at-risk mental state (ARMS) for psychosis. We aimed to examine sex differences in symptomatology, cognition, social and role functioning in individuals with ARMS, with specific focus on clarifying relationships between sex, negative symptoms and functioning.Methods: One hundred and seventy-seven Chinese participants aged 15-40 years with ARMS were recruited from a specialized early intervention service in Hong Kong. ARMS status was verified by Comprehensive Assessment of At-Risk Mental State. Assessments encompassing symptom profiles, a brief battery of cognitive tests and social and role functioning were conducted. Brief Negative Symptom Scale was adapted to measure negative symptoms at the level of five core domains.Results: Males with ARMS exhibited significantly poorer social functioning and more severe asociality of negative symptoms than female counterparts. Mediation analysis revealed that sex difference in social functioning became statistically insignificant when asocality was included in the model, indicating that asociality mediated the relationship between sex and social functioning. No sex differences were observed in other core domains of negative symptoms, other symptom dimensions, cognitive measures and role functioning.Conclusions: This study suggests that sex differences in ARMS may be less pronounced that those observed in established psychotic disorders. Our findings of differential pattern of asociality between sexes and its mediating role on sex difference in social functioning underscore the importance in investigating negative symptoms at a separable domain-level. Further research is required to identify sex-specific predictors of longitudinal outcomes in at-risk populations.

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Negative symptom dimensions differentially impact on functioning in individuals at-risk for psychosis

Cited by 10 publications

References 56 publications

Negative Symptoms and Functioning in Youth at Risk of Psychosis: A Systematic Review and Meta-analysis

Negative Symptoms and Functioning in Youth at Risk of Psychosis: A Systematic Review and Meta-analysis

Relationship of negative symptom severity with cognitive symptoms and functioning in subjects at ultra‐high risk for psychosis

Sex differences in symptom severity, cognition and psychosocial functioning among individuals with at‐risk mental state for psychosis

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