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Prediction of drop-out and functional impairment in recent-onset schizophrenia spectrum disorders

Published online by Cambridge University Press:  13 August 2021

A. Mucci*
Affiliation:
Department Of Psychiatry, Univeristy of Campania Luigi Vanvitelli, Naples, Italy
P. Bucci
Affiliation:
Department Of Psychiatry, Univeristy of Campania Luigi Vanvitelli, Naples, Italy
I. Winter Van Rossum
Affiliation:
Department Of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
C. Arango
Affiliation:
Child And Adolescent Department Of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
L. Baandrup
Affiliation:
Department Of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
B. Glenthøj
Affiliation:
Department Of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
P. Dazzan
Affiliation:
Department Of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, United Kingdom
A. Demjaha
Affiliation:
Department Of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London, United Kingdom
P. Mcguire
Affiliation:
Department Of Psychosis Studies, King’s College London, London, United Kingdom
C. Martínez Díaz-Caneja
Affiliation:
Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
S. Leucht
Affiliation:
Department Of Psychiatry And Psychotherapy, School of Medicine, Technical University Munich, Munich, Germany
R. Rodriguez-Jimenez
Affiliation:
Psychiatry, 12 de Octubre Hospital Research Institute, CIBERSAM, Madrid, Spain
R. Kahn
Affiliation:
Psychiatry, The Mount Sinai Hospital, New York, United States of America
S. Galderisi
Affiliation:
Department Of Psychiatry, Univeristy of Campania Luigi Vanvitelli, Naples, Italy
*
*Corresponding Author.

Abstract

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Persistent negative symptoms are associated with worse outcome in both first-episode and chronic subjects with schizophrenia. The identification of these symptoms in recent-onset subjects is still controversial as retrospective data are often unavailable. The prospective assessment of persistence of negative symptoms might represent a valid alternative but the length of the persistence is still to be established. The present study investigated the prevalence of negative symptoms of moderate severity, unconfounded by depression and extrapyramidal symptoms at baseline in a large cohort of patients in the early stage of a schizophrenia-spectrum disorder, recruited to the OPTiMiSE trial. Persistent unconfounded negative symptoms were assessed at 4, 10 and 22 weeks of treatment. Symptomatic remission, attrition rate and psychosocial functioning was evaluated in subjects with short-term (4 weeks) persistent negative symptoms (PNS) and in those with negative symptoms that did not persist at follow-up and/or were confounded at baseline (N-PNS). Negative symptoms of moderate severity were observed in 59% of subjects at baseline and were associated to worse global functioning. PNS were observed in 7.9% of the cohort, unconfounded at both baseline and end of 4-week treatment. PNS subjects showed lower remission and higher attrition rates at the end of all treatment phases. Fifty-six percent of subjects completing phase 3 (clozapine treatment) had PNS, and 60% of them were non-remitters at the end of this phase. The presence of short-term PNS during the first phases of psychosis was associated with poor clinical outcome and resistance to antipsychotic treatment, including clozapine.

Disclosure

Prof Mucci has been a consultant and/or advisor to or has received honoraria from Gedeon Richter Bulgaria, Janssen Pharmaceuticals, Lundbeck, Otsuka, Pfizer and Pierre Fabre.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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