Negative Symptoms Across Stages of the Psychosis Continuum
Geneviève Sauvé, PhD, of McGill University, Montreal, and colleagues analyzed the course of negative symptoms over the lifetime of patients with psychotic disorders. “Negative symptoms” refer to loss of normal functions, such as anhedonia (decreased ability to experience pleasure), asociality (social withdrawal), avolition (apathy or lack of motivation), alogia (decreased speech), and blunted affect (decreased emotional expression).
The analysis included 47 studies that included patients at different stages along the psychosis continuum. For each negative symptom, prevalence decreased between the “ultra-high risk of developing psychosis” (UHR) and “first episode of psychosis” (FEP) stages, and then increased among “younger patients who have experienced multiple episodes of psychosis” (yMEP).
The findings suggest that negative symptoms are already present in the early stages of the psychosis continuum (UHR and FEP) and that they are most prevalent in the later stage (yMEP). “Early interventions have the potential to reduce the functional limitations associated with negative symptoms,” Dr. Sauvé and coauthors write. They emphasize the importance of attending, in particular, to anhedonia, asociality, and avolition - the three most prevalent types of negative symptoms.