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Developmental influences on symptom expression in antipsychotic-naïve first-episode psychosis.

Abstract：

BACKGROUND:The neurodevelopmental model of psychosis was established over 30 years ago; however, the developmental influence on psychotic symptom expression - how age affects clinical presentation in first-episode psychosis - has not been thoroughly investigated. METHODS:Using generalized additive modeling, which allows for linear and non-linear functional forms of age-related change, we leveraged symptom data from a large sample of antipsychotic-naïve individuals with first-episode psychosis (N = 340, 12-40 years, 1-12 visits), collected at the University of Pittsburgh from 1990 to 2017. We examined relationships between age and severity of perceptual and non-perceptual positive symptoms and negative symptoms. We tested for age-associated effects on change in positive or negative symptom severity following baseline assessment and explored the time-varying relationship between perceptual and non-perceptual positive symptoms across adolescent development. RESULTS:Perceptual positive symptom severity significantly decreased with increasing age (F = 7.0, p = 0.0007; q = 0.003) while non-perceptual positive symptom severity increased with age (F = 4.1, p = 0.01, q = 0.02). Anhedonia severity increased with increasing age (F = 6.7, p = 0.00035; q = 0.0003), while flat affect decreased in severity with increased age (F = 9.8, p = 0.002; q = 0.006). Findings remained significant when parental SES, IQ, and illness duration were included as covariates. There were no developmental effects on change in positive or negative symptom severity (all p > 0.25). Beginning at age 18, there was a statistically significant association between severity of non-perceptual and perceptual symptoms. This relationship increased in strength throughout adulthood. CONCLUSIONS:These findings suggest that as maturation proceeds, perceptual symptoms attenuate while non-perceptual symptoms are enhanced. Findings underscore how pathological brain-behavior relationships vary as a function of development.

journal_name

Psychol Med

journal_title

Psychological medicine

authors

Bridgwater M,Bachman P,Tervo-Clemmens B,Haas G,Hayes R,Luna B,Salisbury DF,Jalbrzikowski M

doi

10.1017/S0033291720003463

subject

Has Abstract

pub_date

2020-10-06 00:00:00

pages

1-12

eissn

0033-2917

issn

1469-8978

pii

S0033291720003463

pub_type

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Developmental influences on symptom expression in antipsychotic-naïve first-episode psychosis.