Longitudinal persistence of negative symptoms in young individuals with first episode schizophrenia: a 24-month multi-modal program follow-up

Abstract

Purpose

Persistent Negative Symptoms (PNS) affect real-world functioning already at the onset of schizophrenia. Longitudinal studies on beneficial effects of psychosocial treatments for PNS in First Episode Schizophrenia (FES) are still relatively scarce. The aim of the current study was to evaluate the longitudinal persistence of PNS in young FES individuals treated according to the multimodal “Early Intervention in Psychosis” (EIP) program over a 2-year follow-up period.

Materials and Methods

133 FES subjects (aged 12–35 years) were recruited within the Italian EIP program and completed the Positive And Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF). In accordance with the PNS criteria, we dichotomized FES individuals with and without PNS. In the FES group with PNS, a multiple linear regression analysis was conducted to examine relevant associations between longitudinal PNS levels and the specialized treatment components of our EIP protocol.

Results

Twenty (15%) FES participants met the PNS criteria. At baseline, PNS levels had relevant positive correlations with functioning decline and PANSS total score. At the end, the 2-years follow-up period, FES subjects with PNS showed a significant decrease in PNS levels. In our linear regression analysis, this reduction was associated with a higher number of individual psychotherapy and case management sessions delivered during our follow-up (together with a shorter DUP [Duration of Untreated Psychosis]).

Conclusions

PNS are clinically relevant in a minority of FES individuals. Our results suggest that patient-tailored psychosocial interventions can reduce clinical severity of PNS over a 2-year period.

Keywords:

• Persistent negative symptoms
• first episode schizophrenia
• early schizophrenia
• treatment response
• early intervention
• follow-up

Acknowledgments

This research received no specific grant from any funding agencies in the public, commercial or not-for-profit sectors.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data that support the findings of the current research are available on request from the corresponding author. The data are not publicly available due to privacy/ethical restrictions.

Additional information

Funding

The “Parma Early Psychosis” (Pr-EP) program was partly financed through a special, treatment-oriented regional fund: “Progetto Esordi Psicotici della Regione Emilia Romagna”.

Notes on contributors

Lorenzo Pelizza

Lorenzo Pelizza, Davide Maestri and Giuseppina Paulillo are psychiatrist of the Parma Department of Mental Health.

Emanuela Leuci

Emanuela Leuci is a psychiatrist of the Parma Department of Mental Health and the Director of the “Parma Early Psychosis Program”.

Davide Maestri

Lorenzo Pelizza, Davide Maestri and Giuseppina Paulillo are psychiatrist of the Parma Department of Mental Health.

Emanuela Quattrone

Emanuela Quattrone is a clinical psychologist of the Parma Department of Mental Health.

Silvia Azzali

Silvia Azzali now is a psychologist of the Reggio Emilia Department of the Mental Health. She previously worked as clinical psychologist of the Parma Early Psychosis program.

Giuseppina Paulillo

Lorenzo Pelizza, Davide Maestri and Giuseppina Paulillo are psychiatrist of the Parma Department of Mental Health.

Pietro Pellegrini

Pietro Pellegrini is the Director of the Parma Department of Mental Health.