Deteriorated Thought and Negative Symptoms Predict 2-Year Social Function Decline in Youth

young man slumped
Researchers found data that showed in youth and adolescents at risk for psychosis, negative symptoms and thought disorder show the propensity toward outcomes.

The presence of deteriorated thought and negative symptoms, including social anhedonia and impairment in personal hygiene, may predict worsening social function over 2 years in young patients at risk for psychosis. This is according to a study in Schizophrenia Research.

Data from the Early Detection and Intervention for the Prevention of Psychosis Program trial, which enrolled youth at risk for psychosis, were included in the study (n=327). Participants were included if they were between the ages of 12 and 25 years, received a score of ≥1 on any Positive Symptom Scale or ≥3 on any Negative Symptom Scale of the Scale of Prodromal Symptoms, and were living in the site’s defined catchment area. The investigators classified patients’ risk for psychosis based on scores from the Scale of Prodromal Symptoms.

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Prospective follow-up and comprehensive evaluations occurred at 6 months, 12 months, and 24 months. Assessments at each follow-up period included the Structured Interview for Prodromal Syndromes and the Global Social and Role Functioning Scales. Overall, the investigators assessed the association between baseline negative and positive symptoms with longitudinal global social and role functioning.

Positive symptoms included unusual thought content, suspiciousness, grandiose ideas, perceptual abnormalities, and bizarre thinking. Negative symptoms included social anhedonia, avolition, expression of emotion, experience of emotions and self, odd behavior or appearance, and impairment in personal hygiene. Deteriorated thought process (ie, disorganized communication, ideational richness, occupational functioning, trouble with focus and attention) and distress (ie, sleep disturbance, dysphoric mood, impaired tolerance to normal stress) were also examined.

Based on linear mixed modeling, the researchers found an association between more severe negative symptoms and deteriorated thought with worse social functioning. Higher positive symptoms were predictive of worse social functioning at baseline; however, more baseline positive symptoms at each follow-up predicted improved social functioning. Overall, the study found that baseline positive symptoms, level of symptom severity, and distress were not reliable predictors of social or role functioning in this cohort.

Limitations of the study include the small sample size in each racial category and the lack of consistent uniform interventions across all patients.

The researchers concluded that diligent evaluation of negative symptoms and deteriorated thought processes at baseline “among adolescents and young adults at risk for psychosis, as well as provision of effective interventions targeting these symptom dimensions, may be helpful to reduce their long-term functional impact.”

Disclosure: A study author declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Burton CZ, Tso IF, Carrión RE, et al. Baseline psychopathology and relationship to longitudinal functional outcome in attenuated and early first episode psychosis [published online August 5, 2019]. Schizophr Res. doi:10.1016/j.schres.2019.07.048