Long-term course of negative symptom subdomains and relationship with outcome in patients with a psychotic disorder

SCHIZOPHRENIA RESEARCH

卷:193

Article

Stiekema, Annemarie P. M.^1,2  Islam, Md Atiqul^3,4,5  Liemburg, Edith J.^3,4,6,7  Castelein, Stynke^3,7  van den Heuvel, Edwin R.⁸  van Weeghel, Jaap^9,10  Aleman, Andre^6,11  Bruggeman, Richard^3,4  van der Meer, Lisette^1,3 

[1] Lentis Psychiat Inst, Dept Rehabil, Zuidlaren, Netherlands

[2] Maastricht Univ, Med Ctr, Fac Hlth Med & Life Sci, Sch Mental Hlth & Neurosci, Maastricht, Netherlands

[3] Univ Groningen, Univ Med Ctr Groningen, Univ Ctr Psychiat, Groningen, Netherlands

[4] Univ Groningen, Univ Med Ctr Groningen, Rob Giel Res Ctr, Groningen, Netherlands

[5] Shahjalal Univ Sci & Technol, Dept Stat, Sylhet 3114, Bangladesh

[6] Univ Groningen, Univ Med Ctr Groningen, Dept Neurosci, Groningen, Netherlands

[7] Lentis Psychiat Inst, Res Dept, Groningen, Netherlands

[8] Eindhoven Univ Technol, Dept Math & Comp Sci, Eindhoven, Netherlands

[9] Dijk Duin Mental Hlth Ctr, Parnassia Grp, Castricum, Netherlands

[10] Tilburg Univ, Tilburg Sch Social & Behav Sci, Dept TRANZO, Tilburg, Netherlands

[11] Univ Groningen, Dept Clin Psychol & Expt Psychopathol, Groningen, Netherlands

关键词: Negative symptoms;    Social amotivation;    Expressive deficits;    Functional outcome;    Long-term course;   

DOI  :  10.1016/j.schres.2017.06.024

来源: Elsevier

【 摘 要 】

Background: The longitudinal course of the negative symptoms subdomains social amotivation (SA) and expressive deficits (ED) remains largely unknown. We investigated i) the longitudinal course of SA and ED subdomain scores, ii) whether subgroups based on the course of SA and ED subdomain scores could be identified, iii) whether baseline SA and ED subdomain scores were related to functioning and quality of life six years later and iv) the longitudinal relationship between subgroups and outcomes. Methods: Measurements at baseline, three and six years from 1067 patients participating in the Genetic Risk and Outcome of Psychosis (GROUP) project were used. We applied mixed models analysis, regression analysis and trajectory analyses. Results: SA and ED subdomain scores decreased over time. Within both subdomains, four subgroups were identified: for both SA and ED a steady low course (+/- 60%), increased (+/- 15%) and decreased course (+/- 15%). Within SA only, a higher level decreased course (+/- 6%) and within ED only, a course with relatively stable high ED scores (+/- 6%) was found. Lower symptom levels at baseline were related to better functioning (SA & ED) and quality of life (SA) at six years. Overall, low SA and low ED subgroups showed better outcomes than the other subgroups. Conclusion: In many patients the course of negative symptoms is unstable and related to the course of outcome. Patients who do show steady low negative symptom levels (60%) may complicate the interpretation of treatment evaluation studies, as they may average out possible effects in subgroups with fluctuating symptom levels. (c) 2017 Elsevier B.V. All rights reserved.

【 授权许可】

Free