title: Duration of attenuated positive and negative symptoms in individuals at clinical high risk: Associations with risk of conversion to psychosis and functional outcome.
abstract: Research in individuals at clinical high-risk (CHR) for psychosis has focused on subjects with no more than 12 months of present or worsened attenuated positive symptoms. However, the impact of long duration attenuated positive and/or negative prodromal symptoms on outcomes is unclear. Seventy-six CHR subjects with attenuated positive symptoms and at least moderate severity level negative symptoms rated on the Scale of Prodromal Symptoms (SOPS) were prospectively followed for a mean of 3.0 ± 1.6 years. Social and Role functioning was assessed with the Global Functioning: Social and Role scales. Correlations between attenuated positive and negative symptom duration and severity and conversion to psychosis and functional outcomes were analyzed. The average onset of SOPS rated negative symptoms (M = 53.24 months, SD = 48.90, median = 37.27) was approximately twelve months prior to the emergence of attenuated positive symptom (M = 40.15 months, SD = 40.33, median = 24.77, P < 0.05). More severe positive symptoms (P = 0.004), but not longer duration of positive (P = 0.412) or negative (P = 0.754) symptoms, predicted conversion to psychosis. Neither positive symptom duration (P = 0.181) nor severity (P = 0.469) predicted role or social functioning at study endpoint. Conversely, longer negative symptom duration predicted poor social functioning (P = 0.004). Overall, our findings suggest that the severity of attenuated positive symptoms at baseline may be more important than symptom duration for determining individuals at increased risk of developing psychosis. In contrast, long-standing negative symptoms may be associated with persistent social difficulties and therefore have an important position in the treatment of disability.
authors.affiliation: Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, 11030, USA; Department of Psychiatry, Hofstra Northwell School of Medicine, Hempstead, NY, 11549, USA. Electronic address: RCarrion@northwell.edu.
authors.forename: Ricardo E
authors.initials: RE
authors.lastname: Carrión
authors.affiliation: Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.
authors.forename: Docia
authors.initials: D
authors.lastname: Demmin
authors.affiliation: Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry, Hofstra Northwell School of Medicine, Hempstead, NY, 11549, USA.
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Auther
authors.affiliation: Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: McLaughlin
authors.affiliation: Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.
authors.forename: Ruth
authors.initials: R
authors.lastname: Olsen
authors.affiliation: Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, 11030, USA; Department of Psychiatry, Hofstra Northwell School of Medicine, Hempstead, NY, 11549, USA; Department of Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, NY, 11549, USA.
authors.forename: Todd
authors.initials: T
authors.lastname: Lencz
authors.affiliation: Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, 11030, USA; Department of Psychiatry, Hofstra Northwell School of Medicine, Hempstead, NY, 11549, USA; Department of Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, NY, 11549, USA.
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Correll
authors.affiliation: Division of Psychiatry Research, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Center for Psychiatric Neuroscience, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, 11030, USA; Department of Psychiatry, Hofstra Northwell School of Medicine, Hempstead, NY, 11549, USA; Department of Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, NY, 11549, USA.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Cornblatt
mesh_terms: D000293:Adolescent; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D062706:Prodromal Symptoms; D016016:Proportional Hazards Models; D011618:Psychotic Disorders / Q000175:diagnosis*; D012307:Risk Factors; D055815:Young Adult
keywords: Attenuated positive symptoms; Clinical high risk; Early intervention; Functional outcome; Negative symptoms; Psychosis