Long-term course of negative symptom subdomains and relationship with outcome in patients with a psychotic disorder

A.P. M Stiekema, Md Atiqul Islam, E.J. Liemburg, S. Castelein, E.R. van den Heuvel, J. van Weeghel, A. Aleman, R. Bruggeman, L. van der Meer, GROUP-investigators

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background:
The longitudinal course of the negative symptoms subdomains social amotivation (SA) and expressive deficits (ED) remains largely unknown. We investigated i) the longitudinal course of SA and ED subdomain scores, ii) whether subgroups based on the course of SA and ED subdomain scores could be identified, iii) whether baseline SA and ED subdomain scores were related to functioning and quality of life six years later and iv) the longitudinal relationship between subgroups and outcomes.

Methods:
Measurements at baseline, three and six years from 1067 patients participating in the Genetic Risk and Outcome of Psychosis (GROUP) project were used. We applied mixed models analysis, regression analysis and trajectory analyses.

Results:
SA and ED subdomain scores decreased over time. Within both subdomains, four subgroups were identified: for both SA and ED a steady low course (±60%), increased (±15%) and decreased course (±15%). Within SA only, a higher level decreased course (±6%) and within ED only, a course with relatively stable high ED scores (±6%) was found. Lower symptom levels at baseline were related to better functioning (SA & ED) and quality of life (SA) at six years. Overall, low SA and low ED subgroups showed better outcomes than the other subgroups.

Conclusion:
In many patients the course of negative symptoms is unstable and related to the course of outcome. Patients who do show steady low negative symptom levels (60%) may complicate the interpretation of treatment evaluation studies, as they may average out possible effects in subgroups with fluctuating symptom levels.

Original languageEnglish
Pages (from-to)173-181
JournalSchizophrenia Research
Volume193
DOIs
Publication statusPublished - 2018

Keywords

  • Adolescent
  • Adult
  • Communication Disorders/etiology
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Motivation/physiology
  • Psychiatric Status Rating Scales
  • Psychotic Disorders/complications
  • Quality of Life
  • Regression Analysis
  • Schizophrenic Psychology
  • Social Behavior Disorders/etiology
  • Young Adult

Cite this

Stiekema, A. P. M., Islam, M. A., Liemburg, E. J., Castelein, S., van den Heuvel, E. R., van Weeghel, J., ... GROUP-investigators (2018). Long-term course of negative symptom subdomains and relationship with outcome in patients with a psychotic disorder. Schizophrenia Research, 193, 173-181. https://doi.org/10.1016/j.schres.2017.06.024
Stiekema, A.P. M ; Islam, Md Atiqul ; Liemburg, E.J. ; Castelein, S. ; van den Heuvel, E.R. ; van Weeghel, J. ; Aleman, A. ; Bruggeman, R. ; van der Meer, L. ; GROUP-investigators. / Long-term course of negative symptom subdomains and relationship with outcome in patients with a psychotic disorder. In: Schizophrenia Research. 2018 ; Vol. 193. pp. 173-181.
@article{c34e65e9baed47d1a65f9e8525e2712a,
title = "Long-term course of negative symptom subdomains and relationship with outcome in patients with a psychotic disorder",
abstract = "Background:The longitudinal course of the negative symptoms subdomains social amotivation (SA) and expressive deficits (ED) remains largely unknown. We investigated i) the longitudinal course of SA and ED subdomain scores, ii) whether subgroups based on the course of SA and ED subdomain scores could be identified, iii) whether baseline SA and ED subdomain scores were related to functioning and quality of life six years later and iv) the longitudinal relationship between subgroups and outcomes.Methods:Measurements at baseline, three and six years from 1067 patients participating in the Genetic Risk and Outcome of Psychosis (GROUP) project were used. We applied mixed models analysis, regression analysis and trajectory analyses.Results: SA and ED subdomain scores decreased over time. Within both subdomains, four subgroups were identified: for both SA and ED a steady low course (±60{\%}), increased (±15{\%}) and decreased course (±15{\%}). Within SA only, a higher level decreased course (±6{\%}) and within ED only, a course with relatively stable high ED scores (±6{\%}) was found. Lower symptom levels at baseline were related to better functioning (SA & ED) and quality of life (SA) at six years. Overall, low SA and low ED subgroups showed better outcomes than the other subgroups.Conclusion:In many patients the course of negative symptoms is unstable and related to the course of outcome. Patients who do show steady low negative symptom levels (60{\%}) may complicate the interpretation of treatment evaluation studies, as they may average out possible effects in subgroups with fluctuating symptom levels.",
keywords = "Adolescent, Adult, Communication Disorders/etiology, Female, Humans, Longitudinal Studies, Male, Middle Aged, Motivation/physiology, Psychiatric Status Rating Scales, Psychotic Disorders/complications, Quality of Life, Regression Analysis, Schizophrenic Psychology, Social Behavior Disorders/etiology, Young Adult",
author = "Stiekema, {A.P. M} and Islam, {Md Atiqul} and E.J. Liemburg and S. Castelein and {van den Heuvel}, E.R. and {van Weeghel}, J. and A. Aleman and R. Bruggeman and {van der Meer}, L. and GROUP-investigators",
note = "Copyright {\circledC} 2017 Elsevier B.V. All rights reserved.",
year = "2018",
doi = "10.1016/j.schres.2017.06.024",
language = "English",
volume = "193",
pages = "173--181",
journal = "Schizophrenia Research",
issn = "0920-9964",
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}

Stiekema, APM, Islam, MA, Liemburg, EJ, Castelein, S, van den Heuvel, ER, van Weeghel, J, Aleman, A, Bruggeman, R, van der Meer, L & GROUP-investigators 2018, 'Long-term course of negative symptom subdomains and relationship with outcome in patients with a psychotic disorder', Schizophrenia Research, vol. 193, pp. 173-181. https://doi.org/10.1016/j.schres.2017.06.024

Long-term course of negative symptom subdomains and relationship with outcome in patients with a psychotic disorder. / Stiekema, A.P. M; Islam, Md Atiqul; Liemburg, E.J.; Castelein, S.; van den Heuvel, E.R.; van Weeghel, J.; Aleman, A.; Bruggeman, R.; van der Meer, L.; GROUP-investigators.

In: Schizophrenia Research, Vol. 193, 2018, p. 173-181.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Long-term course of negative symptom subdomains and relationship with outcome in patients with a psychotic disorder

AU - Stiekema, A.P. M

AU - Islam, Md Atiqul

AU - Liemburg, E.J.

AU - Castelein, S.

AU - van den Heuvel, E.R.

AU - van Weeghel, J.

AU - Aleman, A.

AU - Bruggeman, R.

AU - van der Meer, L.

AU - GROUP-investigators

N1 - Copyright © 2017 Elsevier B.V. All rights reserved.

PY - 2018

Y1 - 2018

N2 - Background:The longitudinal course of the negative symptoms subdomains social amotivation (SA) and expressive deficits (ED) remains largely unknown. We investigated i) the longitudinal course of SA and ED subdomain scores, ii) whether subgroups based on the course of SA and ED subdomain scores could be identified, iii) whether baseline SA and ED subdomain scores were related to functioning and quality of life six years later and iv) the longitudinal relationship between subgroups and outcomes.Methods:Measurements at baseline, three and six years from 1067 patients participating in the Genetic Risk and Outcome of Psychosis (GROUP) project were used. We applied mixed models analysis, regression analysis and trajectory analyses.Results: SA and ED subdomain scores decreased over time. Within both subdomains, four subgroups were identified: for both SA and ED a steady low course (±60%), increased (±15%) and decreased course (±15%). Within SA only, a higher level decreased course (±6%) and within ED only, a course with relatively stable high ED scores (±6%) was found. Lower symptom levels at baseline were related to better functioning (SA & ED) and quality of life (SA) at six years. Overall, low SA and low ED subgroups showed better outcomes than the other subgroups.Conclusion:In many patients the course of negative symptoms is unstable and related to the course of outcome. Patients who do show steady low negative symptom levels (60%) may complicate the interpretation of treatment evaluation studies, as they may average out possible effects in subgroups with fluctuating symptom levels.

AB - Background:The longitudinal course of the negative symptoms subdomains social amotivation (SA) and expressive deficits (ED) remains largely unknown. We investigated i) the longitudinal course of SA and ED subdomain scores, ii) whether subgroups based on the course of SA and ED subdomain scores could be identified, iii) whether baseline SA and ED subdomain scores were related to functioning and quality of life six years later and iv) the longitudinal relationship between subgroups and outcomes.Methods:Measurements at baseline, three and six years from 1067 patients participating in the Genetic Risk and Outcome of Psychosis (GROUP) project were used. We applied mixed models analysis, regression analysis and trajectory analyses.Results: SA and ED subdomain scores decreased over time. Within both subdomains, four subgroups were identified: for both SA and ED a steady low course (±60%), increased (±15%) and decreased course (±15%). Within SA only, a higher level decreased course (±6%) and within ED only, a course with relatively stable high ED scores (±6%) was found. Lower symptom levels at baseline were related to better functioning (SA & ED) and quality of life (SA) at six years. Overall, low SA and low ED subgroups showed better outcomes than the other subgroups.Conclusion:In many patients the course of negative symptoms is unstable and related to the course of outcome. Patients who do show steady low negative symptom levels (60%) may complicate the interpretation of treatment evaluation studies, as they may average out possible effects in subgroups with fluctuating symptom levels.

KW - Adolescent

KW - Adult

KW - Communication Disorders/etiology

KW - Female

KW - Humans

KW - Longitudinal Studies

KW - Male

KW - Middle Aged

KW - Motivation/physiology

KW - Psychiatric Status Rating Scales

KW - Psychotic Disorders/complications

KW - Quality of Life

KW - Regression Analysis

KW - Schizophrenic Psychology

KW - Social Behavior Disorders/etiology

KW - Young Adult

U2 - 10.1016/j.schres.2017.06.024

DO - 10.1016/j.schres.2017.06.024

M3 - Article

VL - 193

SP - 173

EP - 181

JO - Schizophrenia Research

JF - Schizophrenia Research

SN - 0920-9964

ER -