Trajectories of positive, negative and general psychopathology symptoms in first episode psychosis and their relationship with functioning over a 2-year follow-up period

Few studies have examined the trajectories of symptom severity in first episode psychosis (FEP) and their impact on functioning. This study aimed to identify discrete trajectories of positive, negative and general psychopathological symptoms and functioning, determine predictors of the identified sy...

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Published inPloS one Vol. 12; no. 11; p. e0187141
Main Authors Abdin, Edimansyah, Chong, Siow Ann, Vaingankar, Janhavi Ajit, Peh, Chao Xu, Poon, Lye Yin, Rao, Sujatha, Verma, Swapna, Subramaniam, Mythily
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Published United States Public Library of Science 02.11.2017
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Abstract Few studies have examined the trajectories of symptom severity in first episode psychosis (FEP) and their impact on functioning. This study aimed to identify discrete trajectories of positive, negative and general psychopathological symptoms and functioning, determine predictors of the identified symptom trajectories and subsequently investigate the relationship between symptom and functioning trajectories over the 2-year follow-up period. Data were extracted from the Singapore Early Psychosis Intervention Programme clinical database. Trajectories of the Positive and Negative Syndrome Scale and Global Assessment of Functioning (GAF) scale over the two-year follow up were modelled using latent class growth curve modelling. Two distinct trajectories (early response and stable trajectory and delayed response trajectory) for positive symptoms, four distinct trajectories (early response and stable trajectory, early response and relapse trajectory, slower response and no response trajectory and delayed response trajectory) for negative and general psychopathology symptoms and three distinct trajectories for functioning (high functioning trajectory, moderately stable functioning trajectory and deterioration in functioning trajectory) were identified in our sample. Compared to individuals in the early response and stable trajectory, those in the delayed response trajectory for positive and negative symptoms, early response and relapse for negative and general psychopathology symptoms and slower response and no response trajectories for general psychopathology symptoms were significantly associated with higher odds of having deterioration in functioning over time. Poor symptom trajectories were also significantly predicted by younger age, male gender, unemployed and economically inactive status, lower education, longer duration of untreated psychosis and diagnosis of schizophrenia spectrum and delusional disorders. The results confirm that the symptoms trajectories among patients with FEP are heterogeneous and suggest that a small group of patients may be at higher risk of deterioration in symptom severity and functioning over the 2-year follow-up.
AbstractList Few studies have examined the trajectories of symptom severity in first episode psychosis (FEP) and their impact on functioning. This study aimed to identify discrete trajectories of positive, negative and general psychopathological symptoms and functioning, determine predictors of the identified symptom trajectories and subsequently investigate the relationship between symptom and functioning trajectories over the 2-year follow-up period. Data were extracted from the Singapore Early Psychosis Intervention Programme clinical database. Trajectories of the Positive and Negative Syndrome Scale and Global Assessment of Functioning (GAF) scale over the two-year follow up were modelled using latent class growth curve modelling. Two distinct trajectories (early response and stable trajectory and delayed response trajectory) for positive symptoms, four distinct trajectories (early response and stable trajectory, early response and relapse trajectory, slower response and no response trajectory and delayed response trajectory) for negative and general psychopathology symptoms and three distinct trajectories for functioning (high functioning trajectory, moderately stable functioning trajectory and deterioration in functioning trajectory) were identified in our sample. Compared to individuals in the early response and stable trajectory, those in the delayed response trajectory for positive and negative symptoms, early response and relapse for negative and general psychopathology symptoms and slower response and no response trajectories for general psychopathology symptoms were significantly associated with higher odds of having deterioration in functioning over time. Poor symptom trajectories were also significantly predicted by younger age, male gender, unemployed and economically inactive status, lower education, longer duration of untreated psychosis and diagnosis of schizophrenia spectrum and delusional disorders. The results confirm that the symptoms trajectories among patients with FEP are heterogeneous and suggest that a small group of patients may be at higher risk of deterioration in symptom severity and functioning over the 2-year follow-up.
BACKGROUNDFew studies have examined the trajectories of symptom severity in first episode psychosis (FEP) and their impact on functioning. This study aimed to identify discrete trajectories of positive, negative and general psychopathological symptoms and functioning, determine predictors of the identified symptom trajectories and subsequently investigate the relationship between symptom and functioning trajectories over the 2-year follow-up period.METHODSData were extracted from the Singapore Early Psychosis Intervention Programme clinical database. Trajectories of the Positive and Negative Syndrome Scale and Global Assessment of Functioning (GAF) scale over the two-year follow up were modelled using latent class growth curve modelling.RESULTSTwo distinct trajectories (early response and stable trajectory and delayed response trajectory) for positive symptoms, four distinct trajectories (early response and stable trajectory, early response and relapse trajectory, slower response and no response trajectory and delayed response trajectory) for negative and general psychopathology symptoms and three distinct trajectories for functioning (high functioning trajectory, moderately stable functioning trajectory and deterioration in functioning trajectory) were identified in our sample. Compared to individuals in the early response and stable trajectory, those in the delayed response trajectory for positive and negative symptoms, early response and relapse for negative and general psychopathology symptoms and slower response and no response trajectories for general psychopathology symptoms were significantly associated with higher odds of having deterioration in functioning over time. Poor symptom trajectories were also significantly predicted by younger age, male gender, unemployed and economically inactive status, lower education, longer duration of untreated psychosis and diagnosis of schizophrenia spectrum and delusional disorders.CONCLUSIONSThe results confirm that the symptoms trajectories among patients with FEP are heterogeneous and suggest that a small group of patients may be at higher risk of deterioration in symptom severity and functioning over the 2-year follow-up.
Background Few studies have examined the trajectories of symptom severity in first episode psychosis (FEP) and their impact on functioning. This study aimed to identify discrete trajectories of positive, negative and general psychopathological symptoms and functioning, determine predictors of the identified symptom trajectories and subsequently investigate the relationship between symptom and functioning trajectories over the 2-year follow-up period. Methods Data were extracted from the Singapore Early Psychosis Intervention Programme clinical database. Trajectories of the Positive and Negative Syndrome Scale and Global Assessment of Functioning (GAF) scale over the two-year follow up were modelled using latent class growth curve modelling. Results Two distinct trajectories (early response and stable trajectory and delayed response trajectory) for positive symptoms, four distinct trajectories (early response and stable trajectory, early response and relapse trajectory, slower response and no response trajectory and delayed response trajectory) for negative and general psychopathology symptoms and three distinct trajectories for functioning (high functioning trajectory, moderately stable functioning trajectory and deterioration in functioning trajectory) were identified in our sample. Compared to individuals in the early response and stable trajectory, those in the delayed response trajectory for positive and negative symptoms, early response and relapse for negative and general psychopathology symptoms and slower response and no response trajectories for general psychopathology symptoms were significantly associated with higher odds of having deterioration in functioning over time. Poor symptom trajectories were also significantly predicted by younger age, male gender, unemployed and economically inactive status, lower education, longer duration of untreated psychosis and diagnosis of schizophrenia spectrum and delusional disorders. Conclusions The results confirm that the symptoms trajectories among patients with FEP are heterogeneous and suggest that a small group of patients may be at higher risk of deterioration in symptom severity and functioning over the 2-year follow-up.
Few studies have examined the trajectories of symptom severity in first episode psychosis (FEP) and their impact on functioning. This study aimed to identify discrete trajectories of positive, negative and general psychopathological symptoms and functioning, determine predictors of the identified symptom trajectories and subsequently investigate the relationship between symptom and functioning trajectories over the 2-year follow-up period. Data were extracted from the Singapore Early Psychosis Intervention Programme clinical database. Trajectories of the Positive and Negative Syndrome Scale and Global Assessment of Functioning (GAF) scale over the two-year follow up were modelled using latent class growth curve modelling. Two distinct trajectories (early response and stable trajectory and delayed response trajectory) for positive symptoms, four distinct trajectories (early response and stable trajectory, early response and relapse trajectory, slower response and no response trajectory and delayed response trajectory) for negative and general psychopathology symptoms and three distinct trajectories for functioning (high functioning trajectory, moderately stable functioning trajectory and deterioration in functioning trajectory) were identified in our sample. Compared to individuals in the early response and stable trajectory, those in the delayed response trajectory for positive and negative symptoms, early response and relapse for negative and general psychopathology symptoms and slower response and no response trajectories for general psychopathology symptoms were significantly associated with higher odds of having deterioration in functioning over time. Poor symptom trajectories were also significantly predicted by younger age, male gender, unemployed and economically inactive status, lower education, longer duration of untreated psychosis and diagnosis of schizophrenia spectrum and delusional disorders. The results confirm that the symptoms trajectories among patients with FEP are heterogeneous and suggest that a small group of patients may be at higher risk of deterioration in symptom severity and functioning over the 2-year follow-up.
Background Few studies have examined the trajectories of symptom severity in first episode psychosis (FEP) and their impact on functioning. This study aimed to identify discrete trajectories of positive, negative and general psychopathological symptoms and functioning, determine predictors of the identified symptom trajectories and subsequently investigate the relationship between symptom and functioning trajectories over the 2-year follow-up period. Methods Data were extracted from the Singapore Early Psychosis Intervention Programme clinical database. Trajectories of the Positive and Negative Syndrome Scale and Global Assessment of Functioning (GAF) scale over the two-year follow up were modelled using latent class growth curve modelling. Results Two distinct trajectories (early response and stable trajectory and delayed response trajectory) for positive symptoms, four distinct trajectories (early response and stable trajectory, early response and relapse trajectory, slower response and no response trajectory and delayed response trajectory) for negative and general psychopathology symptoms and three distinct trajectories for functioning (high functioning trajectory, moderately stable functioning trajectory and deterioration in functioning trajectory) were identified in our sample. Compared to individuals in the early response and stable trajectory, those in the delayed response trajectory for positive and negative symptoms, early response and relapse for negative and general psychopathology symptoms and slower response and no response trajectories for general psychopathology symptoms were significantly associated with higher odds of having deterioration in functioning over time. Poor symptom trajectories were also significantly predicted by younger age, male gender, unemployed and economically inactive status, lower education, longer duration of untreated psychosis and diagnosis of schizophrenia spectrum and delusional disorders. Conclusions The results confirm that the symptoms trajectories among patients with FEP are heterogeneous and suggest that a small group of patients may be at higher risk of deterioration in symptom severity and functioning over the 2-year follow-up.
Audience Academic
Author Peh, Chao Xu
Subramaniam, Mythily
Chong, Siow Ann
Poon, Lye Yin
Vaingankar, Janhavi Ajit
Verma, Swapna
Abdin, Edimansyah
Rao, Sujatha
AuthorAffiliation 1 Research Division, Institute of Mental Health, Singapore
2 Department of Early Psychosis Intervention, Institute of Mental Health, Singapore
Chiba Daigaku, JAPAN
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/29095875$$D View this record in MEDLINE/PubMed
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ContentType Journal Article
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2017 Abdin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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Snippet Few studies have examined the trajectories of symptom severity in first episode psychosis (FEP) and their impact on functioning. This study aimed to identify...
Background Few studies have examined the trajectories of symptom severity in first episode psychosis (FEP) and their impact on functioning. This study aimed to...
BACKGROUNDFew studies have examined the trajectories of symptom severity in first episode psychosis (FEP) and their impact on functioning. This study aimed to...
Background Few studies have examined the trajectories of symptom severity in first episode psychosis (FEP) and their impact on functioning. This study aimed to...
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SubjectTerms Adult
Analysis
Antipsychotics
Delayed response
Drug abuse
Emotional behavior
Female
Follow-Up Studies
Gender differences
Health aspects
Humans
Illnesses
Male
Mathematical models
Medicine and Health Sciences
Mental disorders
Mental health
Patients
People and Places
Psychiatric patients
Psychiatry
Psychopathology
Psychosis
Psychotic disorders
Psychotic Disorders - psychology
Psychotropic drugs
Schizophrenia
Signs and symptoms
Singapore
Studies
Substance use disorder
Trajectory analysis
Young Adult
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Title Trajectories of positive, negative and general psychopathology symptoms in first episode psychosis and their relationship with functioning over a 2-year follow-up period
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