Negative Symptoms in Early-Onset Psychosis and Their Association With Antipsychotic Treatment Failure
Year: 2018
Type: article
Study design: Observational Study
Abstract: The prevalence of negative symptoms (NS) at first episode of early-onset psychosis (EOP), and their effect on psychosis prognosis is unclear. In a sample of 638 children with EOP (aged 10-17 y, 51% male), we assessed (1) the prevalence of NS at first presentation to mental health services and (2) whether NS predicted eventual development of multiple treatment failure (MTF) prior to the age of 18 (defined by initiation of a third trial of novel antipsychotic due to prior insufficient response, intolerable adverse-effects or non-adherence). Data were extracted from the electronic health records held by child inpatient and community-based services in South London, United Kingdom. Natural Language Processing tools were used to measure the presence of Marder Factor NS and antipsychotic use. The association between presenting with ≥2 NS and the development of MTF over a 5-year period was modeled using Cox regression. Out of the 638 children, 37.5% showed ≥2 NS at first presentation, and 124 (19.3%) developed MTF prior to the age of 18. The presence of NS at first episode was significantly associated with MTF (adjusted hazard ratio 1.62, 95% CI 1.07-2.46; P = .02) after controlling for a number of potential confounders including psychosis diagnostic classification, positive symptoms, comorbid depression, and family history of psychosis. Other factors associated with MTF included comorbid autism spectrum disorder, older age at first presentation, Black ethnicity, and family history of psychosis. In EOP, NS at first episode are prevalent and may help identify a subset of children at higher risk of responding poorly to antipsychotics.
Source: Schizophrenia Bulletin
Institutions: King's College London, South London and Maudsley NHS Foundation Trust, NIHR Maudsley Biomedical Research Centre, National Institute for Health and Care Research, University of Exeter, Icahn School of Medicine at Mount Sinai, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Salud Mental
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,126
Funders: Fundación Mutua Madrileña, Fundación Alicia Koplowitz, South London and Maudsley NHS Foundation Trust, National Institute for Health and Care Research, Academy of Medical Sciences, King's College London, European Commission, Centro de Investigación Biomédica en Red de Salud Mental, Ministerio de Asuntos Económicos y Transformación Digital, Gobierno de España, Horizon 2020 Framework Programme, Medical Research Council, Menzies Centre for Australian Studies, King's College London, University of London, Instituto de Salud Carlos III, European Regional Development Fund, FP7 Health
Awards: G1297764492, G1874133415, G1897392993, G2017605187, G2166927188, G2895393421, G3903641268, G3921541466, G4401574001, G4403079193, Translating neuroimaging findings from research into clinical practice, G4827590587, G5031224452, G5561451410, NIHR Senior Investigator Award, Predicting clinical and functional outcomes in psychosis using machine learning, OPtimization of Treatment and Management of Schizophrenia in Europe (OPTiMiSE), Risks, benefits and NHS costs associated with antipsychotic medications prescribed to individuals diagnosed with serious mental illness, G6844935297, G7114038015, G7192275438, Neuroimaging platform for characterisation of metabolic co-morbidities in psychotic disorders, What are the clinical and educational risk factors for poor academic outcomes in children with Autistic Spectrum Disorder?, European Network of National Schizophrenia Networks Studying Gene-Environment Interactions, Psychiatric Ratings using Intermediate Stratified Markers - Sofia ref.: 115916, G85705433
OpenAlex ID: W2790797709