Early-Stage Negative Symptom Trajectories and Relationships With 13-Year Outcomes in First-Episode Nonaffective Psychosis
| Autor: | Edwin Hm Lee, Jennifer Y.M. Tang, Christy L.M. Hui, Sherry Kit Wa Chan, Wing Chung Chang, Ryan Wui Hang Ho, Corine Sau Man Wong, Yi Nam Suen, Eric Y.H. Chen |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Psychosis Adolescent Longitudinal Course 03 medical and health sciences Young Adult 0302 clinical medicine Intervention (counseling) medicine Humans Cognitive Dysfunction Longitudinal Studies Stage (cooking) First episode Negative symptom business.industry Depression Middle Aged medicine.disease Functional recovery 030227 psychiatry Psychiatry and Mental health Psychotic Disorders Disease Progression Trajectory analysis Female business 030217 neurology & neurosurgery Clinical psychology Regular Articles |
| Popis: | Negative symptoms are a key treatment target in early psychosis intervention. There is a paucity of research examining longitudinal course of negative symptoms across the initial years of treatment for first-episode psychosis using individual-based trajectory analysis. No study has been conducted investigating differential relationships of early-stage negative symptom trajectories with long-term distal outcomes. This study examined patterns and baseline predictors of negative symptom trajectories over the first 3 years of treatment in 138 patients aged 18-55 years presenting with first-episode nonaffective psychosis, using latent class growth analysis based on symptom ratings measured at 4 different time points (baseline, 1, 2, and 3 years). We further explored prospective relationships of identified trajectory classes with functional and negative symptom outcomes at 13-year follow-up. Our results revealed 3 distinct negative symptom trajectories including minimal-stable (59.6%), mild-stable (29.4%), and high-increasing (11.0%) trajectories. Poorer premorbid adjustment, more severe global cognitive impairment, and depressive symptoms at baseline were found to predict high-increasing trajectory. Among 3 trajectory classes, patients in high-increasing trajectory had the worst functional and negative symptom outcomes at 13-year follow-up, with post hoc analyses demonstrating significant outcome differences between high-increasing and minimal-stable trajectories. Our findings thus affirm a heterogeneous course of negative symptoms in first-episode psychosis and indicate that early-stage negative symptom trajectories are critically associated with long-term outcomes. Patients displaying persistently high negative symptom levels in the initial 3 years of treatment may represent a specific subgroup who necessitates an extended period of early intervention specifically targeting at negative symptoms to promote early functional recovery. |
| Databáze: | OpenAIRE |
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