The latent structure of depressive symptoms across clinical high risk and chronic phases of psychotic illness

Abstract Depressive symptoms are highly prevalent in psychotic populations and result in significant functional impairment. Limited knowledge of whether depressive symptoms are invariant across stages of illness curtails our ability to understand how these relate to illness progression. Clarifying the latent structure of depressive symptoms across stages of illness progression would aid etiological conceptualizations and preventive models. In the present study, one-factor (including all items) and two-factor (depression/hopelessness and guilt/self-depreciation) solutions were specified through confirmatory factor analysis (CFA). Measurement invariance analyses were undertaken across schizophrenia (SCZ; n = 312) and clinical high-risk (CHR; n = 175) groups to estimate whether the same construct is being measured across groups. Clinical correlates of the factors were examined. Results indicated that CHR individuals had a greater proportion of mood disorder diagnoses. Metric invariance held for the one-factor solution, and scalar invariance held for the two-factor solution. Notably, negative symptoms did not correlate with depressive symptoms in the SCZ group, though strong correlations were observed in CHR individuals. Positive symptoms were comparably associated with depressive symptoms in both groups. Results suggest depressive symptoms are more prevalent in CHR individuals. Targeting these symptoms may aid future efforts to identify risk of conversion. Further, some depressive symptoms may be systematically more endorsed in CHR individuals. Separating into depression/hopelessness and guilt/self-depreciation scores may aid comparability across stages of illness progression, though this issue deserves careful attention and future study.

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The relationship of social function to depressive and negative symptoms in individuals at clinical high risk for psychosis

Psychological Medicine ◽

10.1017/s0033291710000802 ◽

2010 ◽

Vol 41 (2) ◽

pp. 251-261 ◽

Cited By ~ 101

Author(s):

C. M. Corcoran ◽

D. Kimhy ◽

M. A. Parrilla-Escobar ◽

V. L. Cressman ◽

A. D. Stanford ◽

...

Keyword(s):

Depressive Symptoms ◽

High Risk ◽

Negative Symptoms ◽

Skills Training ◽

Social Function ◽

Self Report ◽

Clinical High Risk ◽

Social Dysfunction ◽

Relationship Of ◽

The Relationship

BackgroundSocial dysfunction is a hallmark symptom of schizophrenia which commonly precedes the onset of psychosis. It is unclear if social symptoms in clinical high-risk patients reflect depressive symptoms or are a manifestation of negative symptoms.MethodWe compared social function scores on the Social Adjustment Scale-Self Report between 56 young people (aged 13–27 years) at clinical high risk for psychosis and 22 healthy controls. The cases were also assessed for depressive and ‘prodromal’ symptoms (subthreshold positive, negative, disorganized and general symptoms).ResultsPoor social function was related to both depressive and negative symptoms, as well as to disorganized and general symptoms. The symptoms were highly intercorrelated but linear regression analysis demonstrated that poor social function was primarily explained by negative symptoms within this cohort, particularly in ethnic minority patients.ConclusionsAlthough this study demonstrated a relationship between social dysfunction and depressive symptoms in clinical high-risk cases, this association was primarily explained by the relationship of each of these to negative symptoms. In individuals at heightened risk for psychosis, affective changes may be related to a progressive decrease in social interaction and loss of reinforcement of social behaviors. These findings have relevance for potential treatment strategies for social dysfunction in schizophrenia and its risk states and predict that antidepressant drugs, cognitive behavioral therapy and/or social skills training may be effective.

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Longitudinal outcome of attenuated positive symptoms, negative symptoms, functioning and remission in people at clinical high risk for psychosis: a meta-analysis

EClinicalMedicine ◽

10.1016/j.eclinm.2021.100909 ◽

2021 ◽

Vol 36 ◽

pp. 100909

Author(s):

Gonzalo Salazar de Pablo ◽

Filippo Besana ◽

Vincenzo Arienti ◽

Ana Catalan ◽

Julio Vaquerizo-Serrano ◽

...

Keyword(s):

High Risk ◽

Negative Symptoms ◽

Meta Analysis ◽

Positive Symptoms ◽

Clinical High Risk ◽

Longitudinal Outcome

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Secondary sources of negative symptoms in those meeting criteria for a clinical high-risk syndrome

Biological Psychiatry Global Open Science ◽

10.1016/j.bpsgos.2021.05.008 ◽

2021 ◽

Author(s):

Tina Gupta ◽

Gregory P. Strauss ◽

Henry R. Cowan ◽

Andrea Pelletier-Baldelli ◽

Lauren M. Ellman ◽

...

Keyword(s):

High Risk ◽

Negative Symptoms ◽

Clinical High Risk ◽

Secondary Sources

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Association of baseline inflammatory markers and the development of negative symptoms in individuals at clinical high risk for psychosis

Brain Behavior and Immunity ◽

10.1016/j.bbi.2018.11.315 ◽

2019 ◽

Vol 76 ◽

pp. 268-274 ◽

Cited By ~ 18

Author(s):

David R. Goldsmith ◽

Ebrahim Haroon ◽

Andrew H. Miller ◽

Jean Addington ◽

Carrie Bearden ◽

...

Keyword(s):

High Risk ◽

Inflammatory Markers ◽

Negative Symptoms ◽

Clinical High Risk

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Negative symptoms in individuals at clinical high risk of psychosis

Psychiatry Research ◽

10.1016/j.psychres.2012.02.018 ◽

2012 ◽

Vol 196 (2-3) ◽

pp. 220-224 ◽

Cited By ~ 138

Author(s):

Danijela Piskulic ◽

Jean Addington ◽

Kristin S. Cadenhead ◽

Tyrone D. Cannon ◽

Barbara A. Cornblatt ◽

...

Keyword(s):

High Risk ◽

Negative Symptoms ◽

Clinical High Risk

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Delay discounting in youth at clinical high-risk for psychosis and adults with schizophrenia

Psychological Medicine ◽

10.1017/s0033291720000677 ◽

2020 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Lisa A. Bartolomeo ◽

Hannah C. Chapman ◽

Ian M. Raugh ◽

Gregory P. Strauss

Keyword(s):

High Risk ◽

Delay Discounting ◽

Negative Symptoms ◽

Chronic Phase ◽

Reward Processing ◽

Positive Symptoms ◽

Clinical High Risk ◽

Symptom Scale ◽

Processing Mechanism ◽

Value Representation

Abstract Background Schizophrenia (SZ) is typically preceded by a prodromal (i.e. pre-illness) period characterized by attenuated positive symptoms and declining functional outcome. Negative symptoms are prominent among individuals at clinical high-risk (CHR) for psychosis (i.e. those with prodromal syndromes) and highly predictive of conversion to illness. Mechanisms underlying negative symptoms in the CHR population are unclear. Two studies were conducted to evaluate whether abnormalities in a reward processing mechanism thought to be core to negative symptoms in SZ, value representation, also exist in CHR individuals and whether they are associated with negative symptoms transphasically. Methods Study 1 included 33 individuals in the chronic phase of illness who have been diagnosed with schizophrenia or schizoaffective disorder (SZ) and 40 healthy controls (CN). Study 2 included 37 CHR participants and 45 CN. In both studies, participants completed the delay discounting (DD) task as a measure of value representation and the Brief Negative Symptom Scale was rated to measure negative symptoms. Results Results indicated that patients with SZ had steeper discounting rates than CN, indicating impairments in value representation. However, CHR participants were unimpaired on the DD task. In both studies, steeper discounting was associated with greater severity of negative symptoms. Conclusions These findings suggest that deficits in value representation are associated with negative symptoms transphasically.

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