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Negative symptoms in first episode schizophrenia: treatment response across the 2-year follow-up of the “Parma Early Psychosis” program

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Abstract

Negative symptoms (NS) severely interfere with real-world performance, already at the onset of schizophrenia and in “clinical high risk” mental states. However, most of the empirical studies specifically examining treatment effectiveness on NS included patients with stable, prolonged schizophrenia. Moreover, research on psychosocial interventions for NS in early schizophrenia is still relatively scarce. Thus, the aims of this study were (1) to longitudinally monitor the NS stability in young individuals with First Episode Schizophrenia (FES) across a 2-year follow-up period, and (2) to investigate any significant association of NS with functioning, other aspects of FES psychopathology and the specific treatment component effects on NS of an “Early Intervention in Psychosis” (EIP) program during the 2 years of follow-up. At entry, 159 FES participants (aged 12–35 years) completed the Positive And Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF). Spearman’s correlations and multiple linear regression analyses were performed. NS had relevant enduring associations with PANSS disorganization scores and GAF functioning decline. Across the follow-up, FES individuals showed a significant improvement in NS levels. This was specifically associated with the number of individual psychotherapy and intensive case management sessions provided during the 2 years of our EIP program, as well as with the antipsychotic dosage at entry. NS are clinically relevant in FES, already at the enrollment in specialized EIP services. However, their clinical severity seems to decrease over time, together with the delivery of specific, patient-tailored EIP interventions.

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The data that support the findings of the present study are available on request from the corresponding author. The data are not publicly available due to privacy/ethical restrictions.

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Acknowledgements

This research received no specific grant from any funding agencies in the public, commercial or not-for-profit sectors. The “Parma Early Psychosis” (Pr-EP) program was partly financed through a special, treatment-oriented regional fund: “Progetto Esordi Psicotici della Regione Emilia Romagna”. For their facilitating technical and administrative support in the Pr-EP program, the authors gratefully acknowledge the “Early Psychosis Facilitators Group” members (Sabrina Adorni, Andrea Affaticati, Anahi Alzapiedi, Paolo Ampollini, Patrizia Caramanico, Maria Teresa Fusoni, Maria Teresa Gaggiotti, Tiziana Guglielmetti, Maristella Miglioli, Mauro Mozzani, Matteo Rossi, Lucilla Maglio, Matteo Tonna, Fabio Vanni and Matteo Zito) and the “Quality Staff Group” members (Patrizia Ceroni, Stefano Giovanelli, Leonardo Tadonio) of the Parma Department of Mental Health and Pathological Addictions. The authors also wish to thank all the patients and family members who actively participated to the Pr-EP program.

Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. The “Parma Early Psychosis” (Pr-EP) program was partly financed through a special, treatment-oriented regional fund: “Progetto Esordi Psicotici della Regione Emilia Romagna”.

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Authors and Affiliations

  1. Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Largo Palli n. 1/A, 43100, Parma, PR, Italy

    Lorenzo Pelizza, Emanuela Leuci, Davide Maestri, Emanuela Quattrone, Giuseppina Paulillo & Pietro Pellegrini

  2. Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n.2, 43100, Reggio Emilia, Italy

    Silvia Azzali

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  1. Lorenzo Pelizza
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  2. Emanuela Leuci
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Contributions

EL and LP contributed to the study conceptualization and design. Data collection was performed by EL, EQ and SA. Data analysis was performed by LP and DM. The first draft of the manuscript was written by LP and EL. All authors read and approved the final version of the manuscript.

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Correspondence to Lorenzo Pelizza.

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The authors declare that they have no conflict of interest.

Ethics approval

Local relevant ethical approvals were obtained for the study (AVEN Ethics Committee: protocol n. 36102/09.09.2019). The current research has been also carried out in accordance with ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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All the participants (and their parents, if minors) gave their informed consent prior to their inclusion in this retrospective research.

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Not applicable.

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Pelizza, L., Leuci, E., Maestri, D. et al. Negative symptoms in first episode schizophrenia: treatment response across the 2-year follow-up of the “Parma Early Psychosis” program. Eur Arch Psychiatry Clin Neurosci 272, 621–632 (2022). https://doi.org/10.1007/s00406-021-01374-5

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