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Harv Rev Psychiatry. 2020 Nov/Dec;28(6):341-355. doi: 10.1097/HRP.0000000000000273.

Negative Symptoms and Functioning in Youth at Risk of Psychosis: A Systematic Review and Meta-analysis.

Harvard review of psychiatry

Daniel J Devoe, Amy Braun, Thomas Seredynski, Jean Addington

Affiliations

  1. From the Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary.

PMID: 33156155 PMCID: PMC8527275 DOI: 10.1097/HRP.0000000000000273

Abstract

LEARNING OBJECTIVE: After participating in this activity, learners should be better able to:• Evaluate the relationship between negative symptoms and functioning in youth at clinical high risk for psychosis.

AIM: Youth at CHR for psychosis often demonstrate significant negative symptoms and poor functioning, though the magnitude and direction of the relationship between the two remains unknown. The objective of this systematic review is to summarize the relationship between negative symptoms and functioning in CHR samples.

METHOD: Electronic databases CINAHL, EBM, Embase, MEDLINE, and PsycINFO were searched from inception. Studies were selected if they included any study that reported a relationship between negative symptoms and functioning in youth at clinical high risk (CHR). The correlation coefficient r was converted to Cohen's d, and all random-effects meta-analyses were performed using the transformed values.

RESULTS: Forty-one studies met the inclusion criteria, including a total of 4574 individuals at CHR for psychosis. Negative symptom total scores were significantly associated with poorer global functioning (d, -1.40; 95% CI, -1.82 to -0.98; I = 79.4%; p < .001 [9 studies, n = 782]), social functioning (d, -1.10; 95% CI, -1.27 to -0.93; I = 10.40%; p < .001 [12 studies, n = 811]), and role functioning (d, -0.96; 95% CI, -1.17 to -0.76; I = 41.1%; p < .001 [9 studies, n = 881]). In addition, negative symptoms were consistently associated with poor premorbid functioning. When examining negative symptom domains, avolition, anhedonia, and blunted affect were each significantly and independently associated with poorer social functioning and role functioning. In terms of prediction models, negative symptoms contributed to the prediction of lower functioning across multiple studies.

CONCLUSION: This meta-analysis demonstrates a strong relationship between negative symptoms and functioning in youth at clinical high risk for psychosis.

References

  1. Psychiatry Res. 2017 Jan;247:345-351 - PubMed
  2. Schizophr Bull. 2014 Nov;40(6):1452-61 - PubMed
  3. Early Interv Psychiatry. 2015 Aug;9(4):292-9 - PubMed
  4. Schizophr Res. 2014 Sep;158(1-3):241-6 - PubMed
  5. J Clin Psychiatry. 2017 Nov/Dec;78(9):1414-1422 - PubMed
  6. J Nerv Ment Dis. 2004 Jul;192(7):455-63 - PubMed
  7. Schizophr Res. 2011 Nov;132(2-3):140-5 - PubMed
  8. Schizophr Res. 2003 Dec 15;65(2-3):125-37 - PubMed
  9. Control Clin Trials. 1986 Sep;7(3):177-88 - PubMed
  10. Early Interv Psychiatry. 2019 Aug;13(4):810-817 - PubMed
  11. Aust N Z J Psychiatry. 2013 Aug;47(8):762-71 - PubMed
  12. Schizophr Res. 2013 Jun;147(1):125-131 - PubMed
  13. Schizophr Bull. 2007 May;33(3):688-702 - PubMed
  14. Psychol Med. 1998 May;28(3):551-8 - PubMed
  15. Schizophr Res Cogn. 2016 Jul 08;5:21-27 - PubMed
  16. BMJ. 2009 Jul 21;339:b2700 - PubMed
  17. Schizophr Bull. 2012 Nov;38(6):1247-57 - PubMed
  18. Psychiatry Res. 1990 Jan;31(1):25-30 - PubMed
  19. Psychiatry Investig. 2017 Sep;14(5):539-545 - PubMed
  20. Early Interv Psychiatry. 2020 Apr;14(2):188-195 - PubMed
  21. JAMA Psychiatry. 2013 Aug;70(8):793-802 - PubMed
  22. Compr Psychiatry. 2007 Mar-Apr;48(2):155-60 - PubMed
  23. Schizophr Res. 2016 Jul;174(1-3):50-57 - PubMed
  24. JAMA Psychiatry. 2013 Nov;70(11):1133-42 - PubMed
  25. Compr Psychiatry. 2013 Feb;54(2):173-80 - PubMed
  26. Schizophr Res. 2018 Mar;193:435-437 - PubMed
  27. Early Interv Psychiatry. 2019 Apr;13(2):169-180 - PubMed
  28. J Psychiatr Res. 2013 Jun;47(6):783-90 - PubMed
  29. J Epidemiol Community Health. 1998 Jun;52(6):377-84 - PubMed
  30. Schizophr Res. 2014 Aug;157(1-3):299-304 - PubMed
  31. Br J Psychiatry Suppl. 1989 Nov;(7):49-58 - PubMed
  32. J Nerv Ment Dis. 2010 Jan;198(1):28-34 - PubMed
  33. World Psychiatry. 2012 Jun;11(2):73-9 - PubMed
  34. Schizophr Res. 2018 Dec;202:310-315 - PubMed
  35. Psychol Med. 2018 Apr;48(6):983-997 - PubMed
  36. Schizophr Bull. 2018 Jun 6;44(4):807-823 - PubMed
  37. Aust N Z J Psychiatry. 2017 Jan;51(1):83-92 - PubMed
  38. Br J Psychiatry. 1990 Dec;157:853-9 - PubMed
  39. Eur Neuropsychopharmacol. 2013 Mar;23(3):196-204 - PubMed
  40. Schizophr Res. 2012 Dec;142(1-3):96-8 - PubMed
  41. Lancet Psychiatry. 2018 Aug;5(8):664-677 - PubMed
  42. Psychol Med. 2011 Feb;41(2):251-61 - PubMed
  43. Dev Psychopathol. 2013 Nov;25(4 Pt 1):1171-86 - PubMed
  44. Schizophr Res. 2013 Apr;145(1-3):50-5 - PubMed
  45. Harv Rev Psychiatry. 2019 Jan/Feb;27(1):15-32 - PubMed
  46. J Psychiatry Neurosci. 1993 Jan;18(1):18-23 - PubMed
  47. Eur Arch Psychiatry Clin Neurosci. 1995;246(1):17-28 - PubMed
  48. Schizophr Res. 2011 Oct;132(1):1-7 - PubMed
  49. Schizophr Res. 2003 Sep 1;63(1-2):79-88 - PubMed
  50. Schizophr Res. 2017 Jul;185:114-121 - PubMed
  51. Schizophr Bull. 2006 Apr;32(2):214-9 - PubMed
  52. Psychiatry Res. 2012 Apr 30;196(2-3):220-4 - PubMed
  53. J Psychiatr Res. 2016 Oct;81:95-101 - PubMed
  54. Acta Psychiatr Scand. 2017 Mar;135(3):250-258 - PubMed
  55. Schizophr Bull. 2007 May;33(3):772-81 - PubMed
  56. Schizophr Res. 2017 Jun;184:32-38 - PubMed
  57. Schizophr Res. 2015 Dec;169(1-3):204-208 - PubMed
  58. Br J Psychiatry. 1993 Jan;162:80-6 - PubMed
  59. Schizophr Res. 2015 Dec;169(1-3):209-213 - PubMed
  60. Aust N Z J Psychiatry. 2008 Aug;42(8):678-85 - PubMed
  61. Am J Psychiatry. 2013 Feb;170(2):165-72 - PubMed
  62. Schizophr Res. 2008 Feb;99(1-3):119-24 - PubMed
  63. NPJ Schizophr. 2015 Jul 15;1:15020 - PubMed
  64. BMJ. 1997 Sep 13;315(7109):629-34 - PubMed
  65. Syst Rev. 2015 Jan 01;4:1 - PubMed
  66. Front Psychiatry. 2019 Jan 25;9:758 - PubMed
  67. Schizophr Res. 2011 May;128(1-3):117-23 - PubMed
  68. Am J Psychiatry. 1992 Nov;149(11):1543-8 - PubMed
  69. Schizophr Res. 2017 Jun;184:26-31 - PubMed
  70. Schizophr Res. 2006 May;84(1):100-11 - PubMed
  71. Schizophr Bull. 2017 Jan;43(1):64-74 - PubMed
  72. Aust N Z J Psychiatry. 2005 Nov-Dec;39(11-12):964-71 - PubMed
  73. Psychiatry Res. 2015 Aug 30;228(3):808-15 - PubMed
  74. JAMA. 2000 Apr 19;283(15):2008-12 - PubMed
  75. JAMA. 1997 Jun 25;277(24):1940-4 - PubMed
  76. Eur Child Adolesc Psychiatry. 2016 Jan;25(1):7-16 - PubMed
  77. BMC Psychiatry. 2012 Dec 06;12:224 - PubMed
  78. Schizophr Bull. 2019 Sep 11;45(5):1042-1050 - PubMed
  79. Schizophr Res. 2008 Sep;104(1-3):237-45 - PubMed
  80. World Psychiatry. 2014 Oct;13(3):275-87 - PubMed
  81. Psychiatr Serv. 2009 Nov;60(11):1495-503 - PubMed
  82. Schizophr Res. 2011 Oct;132(1):24-7 - PubMed
  83. Schizophr Res. 2005 Nov 1;79(1):137-43 - PubMed
  84. Schizophr Res. 2019 Apr;206:355-361 - PubMed
  85. Schizophr Res. 2011 Dec;133(1-3):22-8 - PubMed
  86. Early Interv Psychiatry. 2011 Aug;5(3):224-32 - PubMed
  87. Schizophr Bull. 2018 Feb 15;44(2):286-296 - PubMed
  88. J Nerv Ment Dis. 2015 May;203(5):328-35 - PubMed
  89. Early Interv Psychiatry. 2012 Nov;6(4):442-9 - PubMed
  90. Arch Gen Psychiatry. 1976 Sep;33(9):1111-5 - PubMed
  91. BMC Med Res Methodol. 2015 Apr 14;15:35 - PubMed
  92. Schizophr Res. 2014 Dec;160(1-3):136-41 - PubMed
  93. Am J Psychiatry. 2011 Aug;168(8):800-5 - PubMed
  94. Eur Arch Psychiatry Clin Neurosci. 2020 Apr;270(3):337-350 - PubMed
  95. Acta Psychiatr Scand. 2000 Apr;101(4):323-9 - PubMed
  96. Psychiatry Investig. 2018 Sep;15(9):876-883 - PubMed
  97. Schizophr Res. 2012 May;137(1-3):147-50 - PubMed
  98. Schizophr Res. 2015 Aug;166(1-3):322-7 - PubMed

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