BACKGROUND Negative symptoms are key features of psychosis-spectrum disorders linked to psychosis development and functional impairments. This study investigated the predictive strength of negative symptoms domains on multiple aspects of real-life functional outcome in individuals at clinical high-risk (CHR) for psychosis. METHODS A total of 146 UHR individuals were enrolled in a randomized, clinical trial (RCT), with this being analyses secondary to the RCT. The participants were assessed at baseline with the Scale for the Assessment of Negative Symptoms (SANS) encompassing the four domains of affect, alogia, avolition, and anhedonia. Functioning measures, encompassing overall-, social-, and role functioning, self-report social functioning, and quality of life, were obtained at 12-month follow-up. Regression analyses elucidated on the relationship between the four negative symptom domains and functional outcomes. RESULTS Anhedonia and avolition were the aspects of negative symptoms most predictive of real-life functioning at 12-month follow-up explaining 7-20% of the variance on the outcome measures. Alogia was predictive of social functioning. These findings were maintained when controlling for the effect of neurocognition, antipsychotic medication, and depressive symptoms. DISCUSSION Our findings show experiential negative symptoms to predict multiple areas of real-life functioning and quality of life, while expressive negative symptoms exert a modest influence on the functional prognosis of CHR individuals. Experiential negative symptoms may therefore constitute an important treatment target in intervention approaches aimed at enhancing the functional outcome of CHR individuals.

中文翻译：

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在临床高危状态下，体验性阴性症状比表达性阴性症状更能预测现实生活中的功能结果

背景阴性症状是与精神病发展和功能障碍相关的精神病谱障碍的关键特征。本研究调查了阴性症状域对精神病临床高危 (CHR) 个体现实生活功能结果的多个方面的预测强度。方法 共有 146 名 UHR 个体参加了一项随机临床试验 (RCT)，这是 RCT 的次要分析。参与者在基线时接受了负面症状评估量表 (SANS) 的评估，该量表包括情感、失语、意志力和快感缺乏四个领域。在 12 个月的随访中获得了包括整体、社会和角色功能、自我报告的社会功能和生活质量在内的功能测量。回归分析阐明了四个阴性症状域与功能结果之间的关系。结果 快感缺失和意志力是最能预测 12 个月随访中真实生活功能的阴性症状方面，解释了结果测量差异的 7-20%。Alogia 可以预测社会功能。当控制神经认知、抗精神病药物和抑郁症状的影响时，这些发现得以维持。讨论 我们的研究结果显示，体验性阴性症状可以预测现实生活中功能和生活质量的多个领域，而表达性阴性症状对 CHR 个体的功能预后产生适度影响。