Correlations between Negative Symptoms and Cognitive Deficits in Individuals at First Psychotic Episode or at High Risk of Psychosis: A Systematic Review
Abstract
:1. Introduction
- Summarize the available evidence on the correlations between negative symptoms and dysfunctions in neurocognition and social cognition in subjects with first-episode psychosis or who are at-risk.
- Identify possible methodological limitations especially relevant to the non-standardized and heterogeneous conceptualization of negative symptoms and the use of different scales for their evaluation.
2. Methods
3. Results
3.1. Search Results
3.2. Risk of Bias and the Methodological Quality of the Retrieved Studies
3.3. Sample Inclusion/Exclusion Criteria and Features of FEP Subjects
3.4. Sample Inclusion/Exclusion Criteria and Features of HR Subjects
(a). Demographic and Clinical Features of FEP Subjects | FEP = 3086 |
Diagnosis, n. of subjects | SCZ = 1508 SCZ-A = 75 Schizophreniform = 290 DD = 227 BPD = 175 SSD-NOS = 451 PD-NOS = 360 |
Psychopharmacological treatment, n. of subjects | SGA = 912 FGA = 142 Anticholinergics = 50 Antidepressants = 13 Antidepressants + benzodiazepines = 1 Antipsychotic-naïve = 179 * |
Mean age of onset range across studies (min.–max.) | 21.9–36.6 ** years |
Mean duration of untreated psychosis/illness across studies (min.–max.) | 1–108 *** months |
Mean age across studies (min.–max.) | 21.4–38.3 years |
Gender, n. of male subjects (% of male subjects) | 1656 (53.7%) |
Mean education across studies (min.–max.) | 10.2–12.6 years |
(b). Demographic and clinical features of HR subjects | HR = 1732 |
Gender, n. of male subjects (% of male subjects) | 1051 (60.6%) |
Diagnosis, n. of subjects | AD = 48; Anxiety disorder = 50; SI-PD = 9; Somatoform disorder = 3; ED = 2; Adjustment disorder = 2; Personality disorder = 15 |
Mean age across studies (min.–max.) | 15.5–26.9 years |
Mean education across studies (min.−max.) | 10.3–14.3 years # |
Psychopharmacological treatment, n. of subjects | Antipsychotic, NOS = 44 SGA = 34 Antipsychotic-naïve = 107 Antidepressants = 52 Mood stabilizers = 11 Benzodiazepines = 11 Psychostimulants = 3 Not currently under antipsychotic medication = 594 ## |
3.5. NS Assessment
3.5.1. Assessment of Negative Symptoms in FEP Subjects
3.5.2. Assessment of Negative Symptoms in HR Subjects
3.6. Assessment of Cognitive Impairment in FEP and HR Subjects
3.7. Correlations between NS and Cognitive Functions in FEP Subjects
3.8. Correlations between NS and Cognitive Functions in Subjects at High Risk of Psychosis
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
References
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Applied Assessment Scale | Studies | |
---|---|---|
PANSS | Negative Subscale—total score N1 Blunted Affect, N2 Emotional Withdrawal, N3 Poor Rapport, N4 Passive/Apathetic Social Withdrawal, N5 Difficulty in abstract thinking, N6 Lack of Spontaneity, and N7 stereotyped thinking | Ayres et al. 2007 [119] Hegde et al. 2013 [68] Lee et al. 2019 [110] Stouten et al. 2017 [118] Saleem et al. 2013 [122] Chan et al. 2006 [105] |
Negative factor: N1 Blunted Affect, N2 Emotional Withdrawal, N3 Poor Rapport, N4 Passive/Apathetic Social Withdrawal, N6 Lack of Spontaneity and Flow of Conversation, G7 Motor Retardation, G13 Disturbance of Volition, G15 Preoccupation, and G16 Active Social Avoidance | Huang et al. 2016 [116] | |
Negative factor: Negative subscale total score plus items G13 Disturbance of Volition and G16 Active Social Avoidance | Piskulic et Addington 2011 [121] | |
Negative factor according to EPA guidance: N1 Blunted Affect, N2 Emotional Withdrawal, N3 Poor Rapport, N4 Passive/Apathetic Social Withdrawal, N6 Lack of Spontaneity, and Flow of Conversation | Engen et al. 2019 [109] | |
SANS | Total score | Rodríguez-Sánchez et al. 2008 [117] Chan et al. 2006 [105] |
Total score excluding attention scale | Bliksted et al. 2017 [114] Buck et al. 2020 [104] Ventura et al. 2015 [112] | |
Negative factor according to EPA guidance excluding attention subscale, inappropriate affect, and poverty in content speech items | Chang et al. 2016 [106] | |
Motivational Deficit: avolition–apathy and anhedonia–asociality subscales Expressive Deficit: Blunted affect subscale and Alogia subscale excluding the poverty of content of speech item | Chang et al. 2017 [107] Chang et al. 2020 [108] Wong et al. 2021 [113] | |
Motivational Deficit: Avolition–Apathy and Anhedonia–asociality subscales Expressive Deficit: Blunted affect subscale and Alogia subscale | Ditlevsen et al. 2020 [115] | |
Individual subscales global scores: Affective flattening, alogia, avolition, and anhedonia–asociality | Trampush et al. 2015 [111] | |
BPRS | Negative affect Cluster: items 16 (Blunted affect), 17 (emotional withdrawal), and 18 (Motor retardation) | Mazza et al. 2012 [120] |
HEN | Expressive Deficit: Affect, Behavior, and speech subscales | Chang et al. 2014 [78] |
Applied Assessment Scale | Studies |
---|---|
SIPS: N1 Social Anhedonia, N2 Avolition, N3 Expression of Emotion, N4 Experience of Emotions and Self, N5 Ideational Richness, and N6 Occupational Functioning | Barbato et al. 2015 [126] Gerritsen et al. 2020 [127] Shin et al. 2016 [125] Lindgren et al. 2010 [128] Meyer et al. 2014 [130] Vargas et al. 2018 [132] Niendam et al. 2006 [124] |
CAARMS | Pelizza et al. 2021 [131] |
SANS Total score | Leanza et al. 2018 [129] |
SANS Excluding attention | Üçok et al. 2021 [31] Glenthøj et al. 2017 [123] |
Processing Speed | Verbal Fluency | Attention/ Vigilance | Working Memory | Verbal Learning and Memory | Visual Learning and Memory | Executive Functions | Social Cognition | |
---|---|---|---|---|---|---|---|---|
Significant correlations In parenthesis, relevant references | 0.282≤ r ≤−0.353 3/5 studies: -Average: [116,117] -Good: [109] | 0.282≤ r ≤−0.353 2/4 studies: -Average: [118] –Poor: [119] | −0.23 ≤ r ≤ −0.34 4/6 studies: -Poor: [68] -Average: [116,118] -Good: [105] | −0.191 ≤ r ≤ −2.98 5/8 studies: -Poor: [68,119] -Average [118] -Good [104,110] | r = −0.38 1/3 studies: -Poor: [68] | r = −0.56 1/5 studies: -Poor: [122] | −0.25 ≤ r ≤−0.49 5/8 studies: -Poor: [122] -Average [116] -Good: [105,106,109] | −0.29 ≤ r ≤ −0.41 4/6 studies: -Average: [114] -Poor [120] -Good [112] -Poor: [121] |
Processing Speed | Verbal Fluency | Attention/ Vigilance | Working Memory | Verbal Learning and Memory | Visual Learning and Memory | Executive Functions | Social Cognition | |
---|---|---|---|---|---|---|---|---|
Significant correlations In parenthesis, relevant references | −0.21 ≤ r ≤ −0.40 3/4 studies: -Poor: [128,130] -Average: [31] | −0.40 ≤ r ≤ −0.46 2/3 studies: -Average: [125] -Poor: [129] | −0.26 ≤ r ≤−0.32 3/4 studies: -Average: [31] -Poor: [127,130] | −0.21≤ r ≤−0.38 2/4 studies: -Average: [31] -Poor: [127] | =−0.21≤ r ≤−0.38 4/6 studies: -Poor: [128,130,132] -Average: [125] | 0/3 studies | −0.21≤ r ≤ −0.33 3/6 studies: -Poor: [130] -Average: [31] -Poor: [130] | −0.38≤ r ≤ −0.40 2/3 studies: -Poor: [127,131] |
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Melillo, A.; Caporusso, E.; Giordano, G.M.; Giuliani, L.; Pezzella, P.; Perrottelli, A.; Bucci, P.; Mucci, A.; Galderisi, S. Correlations between Negative Symptoms and Cognitive Deficits in Individuals at First Psychotic Episode or at High Risk of Psychosis: A Systematic Review. J. Clin. Med. 2023, 12, 7095. https://doi.org/10.3390/jcm12227095
Melillo A, Caporusso E, Giordano GM, Giuliani L, Pezzella P, Perrottelli A, Bucci P, Mucci A, Galderisi S. Correlations between Negative Symptoms and Cognitive Deficits in Individuals at First Psychotic Episode or at High Risk of Psychosis: A Systematic Review. Journal of Clinical Medicine. 2023; 12(22):7095. https://doi.org/10.3390/jcm12227095
Chicago/Turabian StyleMelillo, Antonio, Edoardo Caporusso, Giulia Maria Giordano, Luigi Giuliani, Pasquale Pezzella, Andrea Perrottelli, Paola Bucci, Armida Mucci, and Silvana Galderisi. 2023. "Correlations between Negative Symptoms and Cognitive Deficits in Individuals at First Psychotic Episode or at High Risk of Psychosis: A Systematic Review" Journal of Clinical Medicine 12, no. 22: 7095. https://doi.org/10.3390/jcm12227095
APA StyleMelillo, A., Caporusso, E., Giordano, G. M., Giuliani, L., Pezzella, P., Perrottelli, A., Bucci, P., Mucci, A., & Galderisi, S. (2023). Correlations between Negative Symptoms and Cognitive Deficits in Individuals at First Psychotic Episode or at High Risk of Psychosis: A Systematic Review. Journal of Clinical Medicine, 12(22), 7095. https://doi.org/10.3390/jcm12227095