Momentary manifestations of negative symptoms as predictors of clinical outcomes in people at high risk for psychosis: Experience sampling study

I. Paetzold, K.S.F.M. Hermans, A. Schick, B. Nelson, E. Velthorst, F. Schirmbeck, J. van Os, C. Morgan, M. van der Gaag, L. de Haan, L. Valmaggia, P. McGuire, M. Kempton, I. Myin-Germeys, U. Reininghaus

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

© 2021 JMIR Publications Inc.. All rights reserved.Background: Negative symptoms occur in individuals at ultrahigh risk (UHR) for psychosis. Although there is evidence that observer ratings of negative symptoms are associated with level of functioning, the predictive value of subjective experience in daily life for individuals at UHR has not been studied yet. Objective: This study therefore aims to investigate the predictive value of momentary manifestations of negative symptoms for clinical outcomes in individuals at UHR. Methods: Experience sampling methodology was used to measure momentary manifestations of negative symptoms (blunted affective experience, lack of social drive, anhedonia, and social anhedonia) in the daily lives of 79 individuals at UHR. Clinical outcomes (level of functioning, illness severity, UHR status, and transition status) were assessed at baseline and at 1- and 2-year follow-ups. Results: Lack of social drive, operationalized as greater experienced pleasantness of being alone, was associated with poorer functioning at the 2-year follow-up (b=-4.62, P=.01). Higher levels of anhedonia were associated with poorer functioning at the 1-year follow-up (b=5.61, P=.02). Higher levels of social anhedonia were associated with poorer functioning (eg, disability subscale: B=6.36, P=.006) and greater illness severity (b=-0.38, P=.045) at the 1-year follow-up. In exploratory analyses, there was evidence that individuals with greater variability of positive affect (used as a measure of blunted affective experience) experienced a shorter time to remission from UHR status at follow-up (hazard ratio=4.93, P=.005). Conclusions: Targeting negative symptoms in individuals at UHR may help to predict clinical outcomes and may be a promising target for interventions in the early stages of psychosis.
Original languageEnglish
Article numbere30309
JournalJMIR mental health
Volume8
Issue number11
DOIs
Publication statusPublished - 1 Nov 2021

Funding

The authors sincerely thank the participants and all researchers involved in the data collection. This work was supported by a Postdoctoral Research Fellowship of the UK National Institute for Health Research (UR, NIHR-PDF-201104065); a Heisenberg professorship from the German Research Foundation (UR, grant no. 389624707); financial support from the National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and King’s College London; a FWO (Flemish Science Foundation) Odysseus grant (IM-G, G0F8416N); a NHMRC Senior Research Fellowship (BN, 1137687); the Beatrice and Samuel A Seaver Foundation (EV); and the Wellcome Trust (CM, WT087417). This work is an approved add-on study of the “The European Network of National Schizophrenia Networks studying Gene-Environment Interactions ” (EU-GEI), which is supported by funding from the European Union (European Community’s Seventh Framework Program [HEALTH-F2-2009–241909; Project EU-GEI]).

FundersFunder number
Biomedical Research Centre for Mental Health
EU-GEI
Flemish Science FoundationG0F8416N
King’s College London
South London and Maudsley NHS Foundation Trust
Wellcome TrustWT087417
Seventh Framework ProgrammeHEALTH-F2-2009–241909
Beatrice and Samuel A. Seaver Foundation
National Institute for Health ResearchNIHR-PDF-201104065
European Commission
National Health and Medical Research Council1137687
Deutsche Forschungsgemeinschaft389624707
Fonds Wetenschappelijk Onderzoek

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