Abstract
Background
Negative symptoms are key features of schizophrenia spectrum disorders that are linked to psychosis development and functional impairments. This study investigated the predictive power of negative symptoms domains on multiple aspects of real-life functional outcome in individuals at Ultra High-Risk (UHR) for psychosis.
Methods
A total of 146 UHR individuals were enrolled in a randomised, clinical trial. This study reports on analyses secondary to the RCT. The UHR individuals were assessed at baseline with the Scale for the Assessment of Negative Symptoms (SANS) encompassing the four domains of affect, alogia, avolition, and anhedonia. Functioning measures, comprising overall-, social-, and role functioning, self-report social functioning, and quality of life, were obtained at 12-month follow-up. Regression analyses elucidated on the relationship between the four negative symptom domains and functional outcomes.
Results
The aspects of negative symptoms most predictive of real-life functioning at 12-month follow-up were anhedonia and avolition explaining 6–19% of the variance on the functional outcome measures. The finding was maintained when controlling for the effect of neurocognition, antipsychotic medication, and depressive symptoms.
Discussion
Our study finds experiential negative symptoms to predict multiple areas of real-life functioning and quality of life, while expressive negative symptoms exert a modest influence on the functional prognosis of UHR individuals. Hence, experiential negative symptoms (such as motivational deficits and asociality) may constitute an important treatment target in intervention approaches aimed at enhancing the functional outcome of UHR individuals.