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The relationship of social function to depressive and negative symptoms in individuals at clinical high risk for psychosis

Published online by Cambridge University Press:  06 May 2010

C. M. Corcoran ,
D. Kimhy ,
M. A. Parrilla-Escobar ,
V. L. Cressman ,
A. D. Stanford ,
J. Thompson ,
S. Ben David ,
A. Crumbley ,
S. Schobel  and
H. Moore
...Show all authors
C. M. Corcoran*
Affiliation:
Centre of Prevention and Evaluation, New York State Psychiatric Institute at Columbia University, New York, NY, USA
D. Kimhy
Affiliation:
Centre of Prevention and Evaluation, New York State Psychiatric Institute at Columbia University, New York, NY, USA
M. A. Parrilla-Escobar
Affiliation:
Centre of Prevention and Evaluation, New York State Psychiatric Institute at Columbia University, New York, NY, USA
V. L. Cressman
Affiliation:
Centre of Prevention and Evaluation, New York State Psychiatric Institute at Columbia University, New York, NY, USA
A. D. Stanford
Affiliation:
Centre of Prevention and Evaluation, New York State Psychiatric Institute at Columbia University, New York, NY, USA
J. Thompson
Affiliation:
Centre of Prevention and Evaluation, New York State Psychiatric Institute at Columbia University, New York, NY, USA
S. Ben David
Affiliation:
Centre of Prevention and Evaluation, New York State Psychiatric Institute at Columbia University, New York, NY, USA
A. Crumbley
Affiliation:
Centre of Prevention and Evaluation, New York State Psychiatric Institute at Columbia University, New York, NY, USA
S. Schobel
Affiliation:
Centre of Prevention and Evaluation, New York State Psychiatric Institute at Columbia University, New York, NY, USA
H. Moore
Affiliation:
Centre of Prevention and Evaluation, New York State Psychiatric Institute at Columbia University, New York, NY, USA
D. Malaspina
Affiliation:
NYU Department of Psychiatry, Institute for Social and Psychiatric Initiatives (InSPIRES), New York, NY, USA
*
*Address for correspondence: C. M. Corcoran, M.D., Center of Prevention and Evaluation (COPE), Department of Psychiatry, NYSPI at Columbia, Unit 55, 1051 Riverside Drive, New York, NY 10032, USA. (Email: [email protected])
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Abstract

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.

Keywords

Clinical high risknegative symptomspsychosissocial functionultra high risk
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 2 , February 2011 , pp. 251 - 261
Copyright
Copyright © Cambridge University Press 2010

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