Cargando…

T121. BLUNTED AFFECT EARLY PROGRESSION IN DRUG-NAïVE FIRST EPISODE SCHIZOPHRENIA PATIENTS: 10-WEEK FOLLOW UP

BACKGROUND: The study of individual negative symptoms is encouraged as they may have separate neurobiological substrates and require specific therapeutic strategies. Blunted affect is a decrease in the observed expression of emotion and may be more fluctuant than expected. We aim to investigate earl...

Descripción completa

Detalles Bibliográficos
Autores principales: Kagan, Simão, Coutinho, Luccas, Cavalcante, Daniel, Noto, Mariane, Nakamura, André, Bressan, Rodrigo A, Cordeiro, Quirino, Belangero, Sintia, Noto, Cristiano, Gadelha, Ary, Neto, Ary Gadelha de Alencar Araripe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234580/
http://dx.doi.org/10.1093/schbul/sbaa029.681
_version_ 1783535796767162368
author Kagan, Simão
Coutinho, Luccas
Cavalcante, Daniel
Noto, Mariane
Nakamura, André
Bressan, Rodrigo A
Cordeiro, Quirino
Belangero, Sintia
Noto, Cristiano
Gadelha, Ary
Neto, Ary Gadelha de Alencar Araripe
Gadelha, Ary
author_facet Kagan, Simão
Coutinho, Luccas
Cavalcante, Daniel
Noto, Mariane
Nakamura, André
Bressan, Rodrigo A
Cordeiro, Quirino
Belangero, Sintia
Noto, Cristiano
Gadelha, Ary
Neto, Ary Gadelha de Alencar Araripe
Gadelha, Ary
author_sort Kagan, Simão
collection PubMed
description BACKGROUND: The study of individual negative symptoms is encouraged as they may have separate neurobiological substrates and require specific therapeutic strategies. Blunted affect is a decrease in the observed expression of emotion and may be more fluctuant than expected. We aim to investigate early trajectories of blunted affect in first episode schizophrenia (FES) patients without previous antipsychotic-treatment. METHODS: We included 82 first episode psychosis antipsychotic naïve patients meeting the DSM-IV criteria for schizophrenia, schizoaffective or schizophreniform disorder. All participant started risperidone (1-4mg) after the first assessment. Socioeconomic and demographic data were collected at baseline. Positive and Negative Syndrome Scale (PANSS) was applied at both assessments. PANSS negative component item N1 was used to access blunted affect. Participants were divided into three groups for each assessment according to their N1 score: (i) absence of symptoms - score 1 or 2; (ii) Mild intensity - score 3 or 4; and (iii) Severe intensity - score 5 to 7. RESULTS: Mean age was 25.77 (sd: ±7.27) years-old and 61% were male. Mean total PANSS was 92.74 (sd: ± 22.37) at baseline and 65.54 (sd: ± 20.42) at follow up. Mean risperidone dose at follow up was 3.71 (± 1.51). Forty three (52%) study participants had persistence of blunted affect at 10-week follow up regardless of symptom intensity. Sixteen (19.5%) patients never displayed blunted affect. In fact, the most common trajectories include participants who persists with the same symptom severity (n=48). Symptoms improved in 17 participants and got worse in 17 as well. Only one participant started the study without symptom and evolved to high intensity at follow up, while no participant started the study with high severity symptoms and evolved to absence of symptoms. DISCUSSION: Our study suggests that blunted affect exhibit different trajectories, but its intensity tends to remain stable over short-term follow up. Blunted affect may be unresponsive to risperidone at the beginning of treatment. Most of the previous studies addressed trajectories of negative symptoms as a group. Only few addressed the progression of blunted affect and, to the best of our knowledge, this is the first to use a sample of drug-naïve FES patients. Also, we selected only participants in use of risperidone after first assessment in order to reduce bias. A sample of drug naïve FES patients brings opportunities like assessing the course of blunted affect at an early phase of the condition and reducing confounders such as chronicity and exposure to antipsychotics.
format Online
Article
Text
id pubmed-7234580
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-72345802020-05-23 T121. BLUNTED AFFECT EARLY PROGRESSION IN DRUG-NAïVE FIRST EPISODE SCHIZOPHRENIA PATIENTS: 10-WEEK FOLLOW UP Kagan, Simão Coutinho, Luccas Cavalcante, Daniel Noto, Mariane Nakamura, André Bressan, Rodrigo A Cordeiro, Quirino Belangero, Sintia Noto, Cristiano Gadelha, Ary Neto, Ary Gadelha de Alencar Araripe Gadelha, Ary Schizophr Bull Poster Session III BACKGROUND: The study of individual negative symptoms is encouraged as they may have separate neurobiological substrates and require specific therapeutic strategies. Blunted affect is a decrease in the observed expression of emotion and may be more fluctuant than expected. We aim to investigate early trajectories of blunted affect in first episode schizophrenia (FES) patients without previous antipsychotic-treatment. METHODS: We included 82 first episode psychosis antipsychotic naïve patients meeting the DSM-IV criteria for schizophrenia, schizoaffective or schizophreniform disorder. All participant started risperidone (1-4mg) after the first assessment. Socioeconomic and demographic data were collected at baseline. Positive and Negative Syndrome Scale (PANSS) was applied at both assessments. PANSS negative component item N1 was used to access blunted affect. Participants were divided into three groups for each assessment according to their N1 score: (i) absence of symptoms - score 1 or 2; (ii) Mild intensity - score 3 or 4; and (iii) Severe intensity - score 5 to 7. RESULTS: Mean age was 25.77 (sd: ±7.27) years-old and 61% were male. Mean total PANSS was 92.74 (sd: ± 22.37) at baseline and 65.54 (sd: ± 20.42) at follow up. Mean risperidone dose at follow up was 3.71 (± 1.51). Forty three (52%) study participants had persistence of blunted affect at 10-week follow up regardless of symptom intensity. Sixteen (19.5%) patients never displayed blunted affect. In fact, the most common trajectories include participants who persists with the same symptom severity (n=48). Symptoms improved in 17 participants and got worse in 17 as well. Only one participant started the study without symptom and evolved to high intensity at follow up, while no participant started the study with high severity symptoms and evolved to absence of symptoms. DISCUSSION: Our study suggests that blunted affect exhibit different trajectories, but its intensity tends to remain stable over short-term follow up. Blunted affect may be unresponsive to risperidone at the beginning of treatment. Most of the previous studies addressed trajectories of negative symptoms as a group. Only few addressed the progression of blunted affect and, to the best of our knowledge, this is the first to use a sample of drug-naïve FES patients. Also, we selected only participants in use of risperidone after first assessment in order to reduce bias. A sample of drug naïve FES patients brings opportunities like assessing the course of blunted affect at an early phase of the condition and reducing confounders such as chronicity and exposure to antipsychotics. Oxford University Press 2020-05 2020-05-18 /pmc/articles/PMC7234580/ http://dx.doi.org/10.1093/schbul/sbaa029.681 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Session III
Kagan, Simão
Coutinho, Luccas
Cavalcante, Daniel
Noto, Mariane
Nakamura, André
Bressan, Rodrigo A
Cordeiro, Quirino
Belangero, Sintia
Noto, Cristiano
Gadelha, Ary
Neto, Ary Gadelha de Alencar Araripe
Gadelha, Ary
T121. BLUNTED AFFECT EARLY PROGRESSION IN DRUG-NAïVE FIRST EPISODE SCHIZOPHRENIA PATIENTS: 10-WEEK FOLLOW UP
title T121. BLUNTED AFFECT EARLY PROGRESSION IN DRUG-NAïVE FIRST EPISODE SCHIZOPHRENIA PATIENTS: 10-WEEK FOLLOW UP
title_full T121. BLUNTED AFFECT EARLY PROGRESSION IN DRUG-NAïVE FIRST EPISODE SCHIZOPHRENIA PATIENTS: 10-WEEK FOLLOW UP
title_fullStr T121. BLUNTED AFFECT EARLY PROGRESSION IN DRUG-NAïVE FIRST EPISODE SCHIZOPHRENIA PATIENTS: 10-WEEK FOLLOW UP
title_full_unstemmed T121. BLUNTED AFFECT EARLY PROGRESSION IN DRUG-NAïVE FIRST EPISODE SCHIZOPHRENIA PATIENTS: 10-WEEK FOLLOW UP
title_short T121. BLUNTED AFFECT EARLY PROGRESSION IN DRUG-NAïVE FIRST EPISODE SCHIZOPHRENIA PATIENTS: 10-WEEK FOLLOW UP
title_sort t121. blunted affect early progression in drug-naïve first episode schizophrenia patients: 10-week follow up
topic Poster Session III
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234580/
http://dx.doi.org/10.1093/schbul/sbaa029.681
work_keys_str_mv AT kagansimao t121bluntedaffectearlyprogressionindrugnaivefirstepisodeschizophreniapatients10weekfollowup
AT coutinholuccas t121bluntedaffectearlyprogressionindrugnaivefirstepisodeschizophreniapatients10weekfollowup
AT cavalcantedaniel t121bluntedaffectearlyprogressionindrugnaivefirstepisodeschizophreniapatients10weekfollowup
AT notomariane t121bluntedaffectearlyprogressionindrugnaivefirstepisodeschizophreniapatients10weekfollowup
AT nakamuraandre t121bluntedaffectearlyprogressionindrugnaivefirstepisodeschizophreniapatients10weekfollowup
AT bressanrodrigoa t121bluntedaffectearlyprogressionindrugnaivefirstepisodeschizophreniapatients10weekfollowup
AT cordeiroquirino t121bluntedaffectearlyprogressionindrugnaivefirstepisodeschizophreniapatients10weekfollowup
AT belangerosintia t121bluntedaffectearlyprogressionindrugnaivefirstepisodeschizophreniapatients10weekfollowup
AT notocristiano t121bluntedaffectearlyprogressionindrugnaivefirstepisodeschizophreniapatients10weekfollowup
AT gadelhaary t121bluntedaffectearlyprogressionindrugnaivefirstepisodeschizophreniapatients10weekfollowup
AT netoarygadelhadealencarararipe t121bluntedaffectearlyprogressionindrugnaivefirstepisodeschizophreniapatients10weekfollowup
AT gadelhaary t121bluntedaffectearlyprogressionindrugnaivefirstepisodeschizophreniapatients10weekfollowup