Premorbid, clinical and cognitive correlates of primary negative symptoms in first-episode psychosis
Abstract
Negative symptoms are a core psychopathological dimension of psychotic disorders. Previous research on primary negative symptoms (PNS) mostly focused on chronic samples. Data regarding premorbid, clinical and cognitive correlates of PNS in the early illness course are limited and inconsistent. In this study, we assessed 355 Hong Kong Chinese adult patients presenting with first-episode psychosis (FEP) to early intervention service with an aim to examine the prevalence of PNS and its relationships with premorbid adjustment, clinical and cognitive profiles. PNS was defined as the presence of clinically significant negative symptoms excluding depression, positive symptoms and extrapyramidal signs. Results showed that 14.6% of patients exhibited PNS at service entry. PNS group had poorer premorbid social functioning, lower level of insight, and worse performance in Modified Wisconsin Card Sorting and digit symbol tests than non-PNS group. Logistic regression analysis showed that premorbid social functioning and digit symbol test score were independently associated with PNS. Our findings thus indicate that PNS are frequently observed in FEP patients. Deficits in proceeding speed, alongside impaired premorbid social functioning, might be specifically related to PNS in the early illness stage.
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Poor clinical insight is associated with negative symptoms.
“Literature supporting this includes studies correlating poor clinical insight with overall symptom severity [43][44][45] , positive symptoms 46,47 , negative symptoms 44,48,49 , disorganization symptoms 46,47,50-52 , and excitement symptoms 46,47,53 .”
From Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments (2018) · cites this paper as [49]
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Lysaker, P. H., Pattison, M. L., Leonhardt, B. L., Phelps, S., & Vohs, J. L. (2018) · World Psychiatry · doi:10.1002/wps.20508 · Cited by 247 · see citing works
- Authors
- Chang, W. C., Lau, C. F. C., Chan, S. S. I., Hui, C. L. M., Chan, S. K. W., Lee, E. H. M., Lin, J., & Chen, E. Y. H.
- Affiliations
- Queen Mary Hospital (CN)
- Corresponding author
- Chang, Wing Chung
- ORCID
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2016-08
- Volume
- 242
- Pages
- 144-149
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2416188013
- Cited by
- 29
- References
- 54
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 1 · 2023: 4 · 2021: 5 · 2020: 4 · 2019: 2 · 2018: 5 · 2017: 3 · 2016: 1
- FWCI
- 3.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- Funders
- Hong Kong Jockey Club Charities Trust (21009144)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- primary negative symptoms, first-episode psychosis, premorbid adjustment, insight, cognitive impairment, digit symbol test, Wisconsin Card Sorting Test, processing speed, early intervention, Hong Kong Chinese patients
- MeSH terms
- Adaptation, Psychological, Adult, Cognition Disorders, Female, Hong Kong, Humans, Male, Middle Aged, Psychopathology, Psychotic Disorders, Social Behavior, Comorbidity, Prevalence, Logistic Models, Disease Progression, Early Intervention, Educational
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