title: The course of negative symptom in first episode psychosis and the relationship with social recovery.
abstract: To investigate trajectories of negative symptoms during the first 12months of treatment for first episode psychosis (FEP), their predictors and relationship to social recovery.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK.
authors.forename: Brioney
authors.initials: B
authors.lastname: Gee
authors.affiliation: Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK. Electronic address: j.hodgekins@uea.ac.uk.
authors.forename: Jo
authors.initials: J
authors.lastname: Hodgekins
authors.affiliation: University of Sussex, Brighton BN1 9RH, UK.
authors.forename: David
authors.initials: D
authors.lastname: Fowler
authors.affiliation: University of Manchester, Oxford Road, Manchester M13 9PL, UK.
authors.forename: Max
authors.initials: M
authors.lastname: Marshall
authors.affiliation: Birmingham and Solihull Mental Health NHS Foundation Trust, UK.
authors.forename: Linda
authors.initials: L
authors.lastname: Everard
authors.affiliation: University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Lester
authors.affiliation: University of Cambridge, Cambridge CB2 1TN, UK.
authors.forename: Peter B
authors.initials: PB
authors.lastname: Jones
authors.affiliation: University of Bristol, Bristol BS8 1TH, UK.
authors.forename: Tim
authors.initials: T
authors.lastname: Amos
authors.affiliation: University of Warwick, Gibbet Hill Road, Coventry CV4 7AL, UK.
authors.forename: Swaran
authors.initials: S
authors.lastname: P Singh
authors.affiliation: University of Chester, Parkgate Road, Chester CH1 4BJ, UK; Cheshire and Wirral Partnership NHS Foundation Trust, UK.
authors.forename: Vimal
authors.initials: V
authors.lastname: Sharma
authors.affiliation: University College London, Gower St, London WC1E 6BT, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Freemantle
authors.affiliation: University of Warwick, Gibbet Hill Road, Coventry CV4 7AL, UK.
authors.forename: Max
authors.initials: M
authors.lastname: Birchwood
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D012044:Regression Analysis; D012737:Sex Factors; D012919:Social Behavior; D016896:Treatment Outcome; D006113:United Kingdom; D055815:Young Adult
keywords: Early intervention; Functioning; Longitudinal; Negative symptoms; Recovery