Persistent negative symptoms in the EULAST cohort: impact on functional outcome.

Area of Science:

• Psychiatry
• Clinical Psychology

Background:

• Persistent negative symptoms (PNS) are linked to poor functional outcomes in schizophrenia.
• Understanding the prevalence and impact of both confounded and unconfounded negative symptoms is essential for early intervention.

Purpose of the Study:

• To confirm the prevalence and clinical impact of unconfounded persistent negative symptoms (PNS) on dropout rates and psychosocial functioning.
• To explore the prevalence of enduring negative symptoms (E-NS) and their influence on functional outcomes.

Main Methods:

• Post-hoc analysis of the European Long-acting Antipsychotics in Schizophrenia Trial (EULAST) cohort.
• Assessment of negative symptoms, depression, parkinsonism, dropout rates, and psychosocial functioning at baseline, 12, and 18 months.

Main Results:

• At baseline, 60.6% of patients had moderate negative symptoms, with 42.8% meeting criteria for unconfounded negative symptoms.
• After 1 year, PNS and E-NS prevalence was 7.9% and 15%, respectively, with ~32% prospective consistency.
• PNS and E-NS groups showed significantly worse functioning at 12 and 18 months compared to non-persistent negative symptoms (N-PNS) groups.

Conclusions:

• Long-term persistence of negative symptoms, whether primary or secondary, significantly contributes to poor functional outcomes in schizophrenia.
• Further research is needed to identify predictors of symptom persistence for targeted intervention development.