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The course of negative symptom in first episode psychosis and the relationship with social recovery.

Accepted version
Peer-reviewed

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Type

Article

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Authors

Gee, Brioney 
Hodgekins, Jo 
Fowler, David 
Marshall, Max 
Everard, Linda 

Abstract

AIMS: To investigate trajectories of negative symptoms during the first 12months of treatment for first episode psychosis (FEP), their predictors and relationship to social recovery. METHOD: 1006 participants were followed up for 12months following acceptance into Early Intervention in Psychosis services. Negative symptom trajectories were modelled using latent class growth analysis (LCGA) and predictors of trajectories examined using multinomial regression. Social recovery trajectories - also modelled using LCGA - of members of each negative symptom trajectory were ascertained and the relationship between negative symptom and social recovery trajectories examined. RESULTS: Four negative symptom trajectories were identified: Minimal Decreasing (63.9%), Mild Stable (13.5%), High Decreasing (17.1%) and High Stable (5.4%). Male gender and family history of non-affective psychosis predicted stably high negative symptoms. Poor premorbid adolescent adjustment, family history of non-affective psychosis and baseline depression predicted initially high but decreasing negative symptoms. Members of the Mild Stable, High Stable and High Decreasing classes were more likely to experience stably low functioning than the Minimal Decreasing class. CONCLUSIONS: Distinct negative symptom trajectories are evident in FEP. Only a small subgroup present with persistently high levels of negative symptoms. A substantial proportion of FEP patients with elevated negative symptoms at baseline will achieve remission of these symptoms within 12months. However, elevated negative symptoms at baseline, whether or not they remit, are associated with poor social recovery, suggesting targeted interventions for service users with elevated baseline negative symptoms may help improve functional outcomes.

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Keywords

Early intervention, Functioning, Longitudinal, Negative symptoms, Recovery, Adolescent, Analysis of Variance, Cost-Benefit Analysis, Disease Progression, Family, Female, Follow-Up Studies, Genetic Predisposition to Disease, Humans, Longitudinal Studies, Male, Psychiatric Status Rating Scales, Psychotic Disorders, Regression Analysis, Sex Factors, Social Behavior, Treatment Outcome, United Kingdom, Young Adult

Journal Title

Schizophr Res

Conference Name

Journal ISSN

0920-9964
1573-2509

Volume Title

Publisher

Elsevier BV