شناسایی تاثیرات در افراد در معرض خطر بالای بالینی ابتلا به روان پریشی

Individuals with schizophrenia demonstrate stable deficits in affect recognition. Similar deficits in affect recognition have been observed in those who are at clinical high risk (CHR) of developing psychosis. The current project aimed to longitudinally examine affect processing in CHR individuals, to determine if affect processing predicted later conversion to psychosis and if affect processing deficits were unique to those who met established criteria for prodromal syndromes. The sample consisted of 172 CHR and 100 help-seeking individuals (HS) who were followed for up to 24 months. All CHR individuals met the Criteria of Prodromal Syndromes (COPS) based on the Structured Interview for Prodromal Symptoms (SIPS). The SIPS was used to determine conversion to psychosis. Affect recognition was assessed using two facial affect recognition tasks and a measure of affective prosody. In comparison to previously published data from non-psychiatric controls, both CHR and HS groups demonstrated deficits in affect recognition. By 2 years 25 CHR participants converted to psychosis. Interestingly, there were no differences between converters and non-converters on any affect recognition tasks. This is one of the first studies to longitudinally examine affect processing and its relationship to later conversion to psychosis in individuals at-risk for psychosis. While poorer affect recognition may be associated with vulnerability for psychosis, the current results suggest that it may not be a marker of developing a psychotic illness.

There is a growing interest in social cognition in schizophrenia, mainly due to its association with poor social functioning (Fett et al., 2011). One of the most studied domains of social cognition is affect recognition. It has been well established that individuals with schizophrenia demonstrate stable deficits in both discrimination and identification of affect irrespective of modality, facial (Addington et al., 2006, Pinkham et al., 2007 and Horan et al., in press) or prosodic (Edwards et al., 2001 and Kucharska-Pietura et al., 2005), and across all stages of illness (Green et al., in press). Similar deficits in affect recognition have been observed in individuals who are putatively prodromal for psychosis, i.e., at clinical high risk (CHR) of developing a psychotic disorder. CHR individuals, relative to healthy controls, have demonstrated impaired performance on facial affect identification comparable to the performance of individuals with a first episode of psychosis and those who have a more chronic course of psychosis (Addington et al., 2008 and Green et al., in press). Amminger et al. (in press), using both a facial affect task as well as a measure of affective prosody, reported similar results relative to healthy controls and first episode patients; CHR individuals exhibited deficits in the recognition of fear and sadness across both face and voice modalities compared to non-psychiatric controls. Although these studies suggest that affect recognition deficits may be a trait-characteristic, there are no longitudinal studies testing the stability of affect recognition in those at clinical high risk or examining its relationship to conversion to psychosis. The aim of this project was to examine longitudinally affect processing in a large sample of individuals at CHR of psychosis, to determine if affect processing was a predictor of later conversion to psychosis and to determine if deficits in affect processing were unique to those who met established criteria for a prodromal syndrome