Negative symptoms in the at-risk mental state - association with transition to psychosis and functional outcome

Presentation First Author: 
Stephen Wood

The at-risk mental state (ARMS) is generally defined by the presence of psychotic symptoms that do not meet the threshold for frank psychotic disorder, because they are attenuated in severity and/or duration. Furthermore, the transition to psychosis is determined on the basis of worsening in these same positive psychotic symptoms. The nature and course of negative symptoms in ARMS individuals is not commonly reported, and no study to date has examined the trajectory of this dimension. Here we present longitudinal data from 266 ARMS individuals (median duration of follow-up 6.6yrs), testing the relevance of baseline negative symptoms for later outcome.We divided the ARMS group into those whose baseline negative symptoms (as assessed with the SANS) were above the 66th percentile (High NS, n=87), and those at or below it (Low NS, n=179). There was no difference in the proportion of each group that developed psychosis over the follow-up interval (31% vs 25%, p=0.39), although more of the High NS group had a current or past diagnosis of schizophrenia (16% vs 6%, p=0.02). The High NS group also had significantly lower functioning at follow-up (SOFAS; 64 vs 69, p=0.01), and significantly lower quality of life (QLS; 90 vs 100, p=0.01).These data indicate the relevance of negative symptoms at baseline for outcome. Though the impact on transition is low, high NS are associated with poor functioning and quality of life many years after initial assessment.

Conference Name: 
Presentation Date: 
January, 2015
Additional Authors: 
Ashleigh Lin - Barnaby Nelson - Pat McGorry - Alison Yung
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