title: Flat affect and social functioning: a 10 year follow-up study of first episode psychosis patients.
abstract: BACKGROUND
  Affective flattening has been described as enduring, but long term follow-up studies of first episode psychosis patients are lacking.
  
  
  OBJECTIVE
  The aim of this study was to follow the symptom development of flat affect (FA), over a 10 year follow-up period, with focus on prevalence, predictors and outcome factors including social functioning.
  
  
  METHODS
  Three-hundred-and-one patients with FEP were included at baseline, 186 participated in the 10 year follow-up. These were followed on PANSS item N1 (FA) from baseline through 5 follow-up assessments over 10 years. Patients were grouped as having never-present, improving, deteriorating, fluctuating or enduring FA. The groups were compared on baseline variables, variables at 10 year follow-up, and social functioning throughout the follow-up period.
  
  
  RESULTS
  Twenty nine percent never displayed FA, 66% had improving, deteriorating or fluctuating FA, while 5% of patients had enduring FA. Premorbid social function predicted enduring FA. The patients with enduring, fluctuating and deteriorating FA did poorer on all outcome variables, including remission and recovery rates. The enduring FA group did significantly poorer in social functioning over the 10 year period.
  
  
  CONCLUSIONS
  FA is expressed at some point of time in the majority of FEP patients in a 10 year follow-up period, and appears more fluctuant than expected from the relevant literature. FA is associated with poorer outcome after 10 years, and enduring FA to poorer social function at all points of assessment.
authors.affiliation: Division of Mental Health and Addiction, Oslo University Hospital, N-0407, Oslo, Norway. j.h.evensen@medisin.uio.no
authors.forename: Julie
authors.initials: J
authors.lastname: Evensen
authors.forename: Jan Ivar
authors.initials: JI
authors.lastname: Røssberg
authors.forename: Helene
authors.initials: H
authors.lastname: Barder
authors.forename: Ulrik
authors.initials: U
authors.lastname: Haahr
authors.forename: Wenche Ten Velden
authors.initials: WT
authors.lastname: Hegelstad
authors.forename: Inge
authors.initials: I
authors.lastname: Joa
authors.forename: Jan Olav
authors.initials: JO
authors.lastname: Johannessen
authors.forename: T K
authors.initials: TK
authors.lastname: Larsen
authors.forename: Ingrid
authors.initials: I
authors.lastname: Melle
authors.forename: Stein
authors.initials: S
authors.lastname: Opjordsmoen
authors.forename: Bjørn Rishovd
authors.initials: BR
authors.lastname: Rund
authors.forename: Erik
authors.initials: E
authors.lastname: Simonsen
authors.forename: Per
authors.initials: P
authors.lastname: Vaglum
authors.forename: Thomas
authors.initials: T
authors.lastname: McGlashan
authors.forename: Svein
authors.initials: S
authors.lastname: Friis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology*; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000523:psychology*; D012919:Social Behavior; D055815:Young Adult