Journal
PSYCHOLOGICAL MEDICINE
Volume 41, Issue 2, Pages 251-261Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291710000802
Keywords
Clinical high risk; negative symptoms; psychosis; social function; ultra high risk
Categories
Funding
- National Institutes of Mental Health [K23MH066279]
- National Alliance for Research on Schizophrenia and Depression (NARSAD)
- Sackler Foundation
- Florence T. Irving Award
- Lieber Schizophrenia Research Program
- Alicia Koplowitz Foundation
- NIMH [K24 MH01699]
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Background. Social dysfunction is a hallmark symptom of schizophrenia which commonly precedes the onset of psychosis. It is unclear if social symptoms in clinical high-risk patients reflect depressive symptoms or are a manifestation of negative symptoms. Method. We compared social function scores on the Social Adjustment Scale-Self Report between 56 young people (aged 13-27 years) at clinical high risk for psychosis and 22 healthy controls. The cases were also assessed for depressive and 'prodromal' symptoms (subthreshold positive, negative, disorganized and general symptoms). Results. Poor social function was related to both depressive and negative symptoms, as well as to disorganized and general symptoms. The symptoms were highly intercorrelated but linear regression analysis demonstrated that poor social function was primarily explained by negative symptoms within this cohort, particularly in ethnic minority patients. Conclusions. Although this study demonstrated a relationship between social dysfunction and depressive symptoms in clinical high-risk cases, this association was primarily explained by the relationship of each of these to negative symptoms. In individuals at heightened risk for psychosis, affective changes may be related to a progressive decrease in social interaction and loss of reinforcement of social behaviors. These findings have relevance for potential treatment strategies for social dysfunction in schizophrenia and its risk states and predict that antidepressant drugs, cognitive behavioral therapy and/or social skills training may be effective.
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