Identifying clinical and psychological correlates of persistent negative symptoms in early-onset psychotic disorders

Karakus O. B. , Ermis C., Tuncturk M., Yuksel A. S. , Alarslan S., Saglam Y., ...More

CLINICAL CHILD PSYCHOLOGY AND PSYCHIATRY, 2022 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2022
  • Doi Number: 10.1177/13591045221075531
  • Journal Indexes: Science Citation Index Expanded, Social Sciences Citation Index, Scopus, Academic Search Premier, ASSIA, Child Development & Adolescent Studies, CINAHL, Educational research abstracts (ERA), EMBASE, MEDLINE, Psycinfo
  • Keywords: Persistent negative symptoms, youth, adolescent, early-onset, schizophrenia, 1ST EPISODE SCHIZOPHRENIA, EXPRESSED EMOTION, DEFICIT SYNDROME, RATING-SCALE, 1ST-EPISODE, VALIDITY, RELIABILITY, RESILIENCE, CHILDREN


Persistent negative symptoms (PNS) contribute to impairment in psychosis. The characteristics of PNS seen in youth remained under-investigated. We aimed to demonstrate clinical, treatment-related, and psychosocial characteristics of PNS in early-onset schizophrenia-spectrum disorders (EOSD). 132 patients with EOSD were assessed with Positive and Negative Symptom Scale, Brief Negative Symptom Scale, Calgary Depression Scale for Schizophrenia, and Simpson-Angus Scale. Parenting skills and resilience were evaluated using Parental Attitude Research Instrument and Child and Youth Resilience Measure-12. Longer duration of untreated psychosis (DUP) and prodromal phase were found in primary and secondary PNS groups, compared to the non-PNS group. The primary PNS group was characterized by earlier age-onset, lower smoking rates, and more common clozapine use. Resilience and egalitarian/democratic parenting were negatively correlated with symptoms related to motivation/pleasure and blunted expression. More blunted expression-related symptoms and longer DUP in the first episode significantly predicted primary/secondary PNS at follow-up. Using the data from total negative symptom scores and DUP, Receiver Operating Characteristic analyses significantly differentiated primary/secondary PNS groups from the non-PNS counterparts. PNS associated with blunted expression and low motivation/pleasure in the first episode could persist into clinical follow-up. Effective pharmacological treatment and psychosocial interventions are needed in youth.