SA128. Primary Negative Symptoms in First-Episode Psychosis: Its Relationship With Functioning and Subjective Quality of Life

Abstract

which they completed on random moments for up to 10 times a day on 7 consecutive days. Attachment anxiety and avoidance were assessed with the Psychosis Attachment Measure and symptoms were assessed with the positive and negative syndrome scale (PANSS). Results: Patients were 2.7 to 3.9 times more likely to be alone than healthy controls and relatives, respectively. In addition, patients showed significantly lower levels of trust compared to relatives and healthy controls around close others (i.e., family or friends) but not when in company of strangers or more distant others. Relatives and controls did not differ from each other in their levels of trust. There were no group differences in attachment anxiety or avoidance. In patients, negative but not positive symptoms were associated with a lower frequency of social engagement. Conclusion:The current study shows reduced trust and social engagement in patients with nonaffective psychosis within real-life contexts. Interestingly, patients' levels of trust were specifically reduced in relationships with close others. This effect was not accounted for by attachment insecurity. The absence of differences in trust and social engagement between controls and relatives suggests that the effects seen in patients are illness specific. Social networks with close others are crucial for wellbeing and recovery and the current findings support the need for improving these in patients. Background: Autism and schizophrenia are associated with difficulties in social perception and understanding. However, the relationship between these conditions and the way they affect social functioning have been a contentious issue. In addition, a dimensional view of psychopathology suggests that subclinical expressions can explain interindividual differences within the healthy population. However, it is debated whether effects found in healthy populations can extend to clinical populations. Methods: We examined covariation of mentalizing abilities as a function of autism and positive symptoms in 162 patients with schizophrenia. We also examined these abilities in 53 healthy adults as a function of attenuated, subclinical expressions of autism and positive symptoms. Mentalizing abilities in both populations were assessed using the Movie for the Assessment of Social Cognition, an ecologically valid task that distinguishes between different types of mentalizing errors, namely underand over-mentalizing. Results: We found that while autism and positive symptom expressions are associated with unique profiles of mentalizing difficulties, they interact in a compensatory manner. In healthy participants, autistic expressions are associated with increased undermentalism, and positive psychotic-like experiences are associated with reduced undermentalism. In schizophrenia patients, autism symptoms are associated with reduced overmentalism and positive symptoms are associated with increased overmentalism. Conclusion: Co-occurring expressions of autistic and positive symptoms exert opposing influences on men...