Self-evaluation of negative symptoms in adolescent and young adult first psychiatric episodes

Negative Symptoms (blunted affect, alogia, anhedonia, avolition, and asociality) are usually described in schizophrenia but they are also present in other psychiatric disorders. The diagnosis and prognosis relevance of negative symptoms (NS) self-assessment during a first psychiatric episode is still unknown.

To determine (i) the rate of self-assessed NS in a first psychiatric episode among adolescents and young adults compared to control subjects; and (ii), whether there is a difference in the prevalence of NS between schizophrenia and major depressive disorder first episodes.

The population included patients aged 15-25 years, with no psychiatric history and no history of medication. A dimensional evaluation was assessed during hospitalization, including depressive (Hamilton Depression Scale), psychotic symptoms (Prodromal Questionnaire, 16 items) and the self-evaluation of negative symptoms (SNS scale). Prospective categorical diagnoses were updated 6 months after hospitalization. The population included 117 individuals (58 patients and 59 healthy controls).

Among healthy individuals, 47.5% reported at least one NS, the most reported being amotivation. After binary logistic regression, Negative Symptoms (SNS score) were associated with a diagnostic of psychiatric disorder at the 6-months follow-up (OR = 1.163, p = .001), whereas depressive symptoms and psychotic experiences were not. A SNS threshold allowed to screen first episode patients and SZ patients in the general population (assessed with ROC curve). A high prevalence of self-reported NS was observed across diagnostic boundaries in first psychiatric episodes, with a mean SNS score of 19.3 ± 7.1 for schizophrenic disorders and 20.7 ± 8.6 for depressive disorders. The prevalence of NS was not significantly different between depressive disorders and schizophrenic disorders (p > .05).

NS are an important transnosographic dimension during first psychiatric episodes among adolescents and young adults. Negative symptoms self-assessment with the SNS scale is relevant during a first psychiatric episode.