Duration of basic and attenuated-psychotic symptoms in individuals at clinical high risk for psychosis: pattern of symptom onset and effects of duration on functioning and cognition

Staines L., Gajwani R., Gross J., Gumley A.I., Lawrie S.M., Schwannauer M., Schultze-Lutter F., Uhlhaas P.J.

Institute for Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom; Royal College of Surgeons in Ireland, Dublin, Ireland; Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom; Institute for Biomagnetism and Biosignalanalysis, University of Muenster, Muenster, Germany; Department of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom; Department of Clinical Psychology, University of Edinburgh, Edinburgh, United Kingdom; Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany; Department of Psychology and Mental Health, Faculty of Psychology, Airlangga University, Surabaya, Indonesia; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany


Introduction: Duration of risk symptoms (DUR) in people at clinical high risk for psychosis (CHR-P) has been related to poorer clinical outcomes, such as reduced functioning, but it is currently unclear how different symptoms emerge as well as their link with cognitive deficits. To address these questions, we examined the duration of basic symptoms (BS) and attenuated psychotic symptoms (APS) in a sample of CHR-P participants to test the hypothesis that BS precede the manifestation of APS. As a secondary objective, we investigated the relationship between DUR, functioning and neuropsychological deficits. Methods: Data from 134 CHR-P participants were assessed with the Comprehensive Assessment of At-Risk Mental State and the Schizophrenia Proneness Interview, Adult Version. Global, role and social functioning and neurocognition were assessed and compared to a sample of healthy controls (n = 57). Results: In CHR-P participants who reported both APS and BS, onset of BS and APS was not significantly related. When divided into short and long BS duration ( 8 years), CHR-P participants with a longer duration of BS showed evidence for an onset of BS preceding APS (n = 8, p = 0.003). However, in the short BS duration group, APS showed evidence of preceding BS (n = 56, p = 0.020). Finally, there were no significant effects of DUR on cognition or functioning measures. Conclusion: The present findings do not support the view that APS constitute a secondary phenomenon to BS. Moreover, our data could also not confirm that DUR has a significant effect on functioning and cognitive deficits. These findings are discussed in the context of current theories regarding emerging psychosis and the importance of DUR. © 2021, The Author(s).

Attenuated psychotic symptoms; Basic symptoms; Clinical high risk for psychosis; Cognition; Duration; Psychosis


BMC Psychiatry

Publisher: BioMed Central Ltd

Volume 21, Issue 1, Art No 339, Page – , Page Count

Journal Link: https://www.scopus.com/inward/record.uri?eid=2-s2.0-85109767851&doi=10.1186%2fs12888-021-03267-2&partnerID=40&md5=93b5f94a1cb7b2211aee1b664b157978

doi: 10.1186/s12888-021-03267-2

Issn: 1471244X

Type: All Open Access, Gold, Green


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