Poor affect recognition may not predict psychosis in high-risk patients

By Mark Cowen, Senior medwireNews Reporter

Decreased affect recognition is associated with psychosis vulnerability, but it is not a marker of conversion to psychosis in high-risk individuals, researchers report.

Indeed, in a 2-year study of patients at clinical high risk (CHR) risk for psychosis, Jean Addington (University of Calgary, Alberta, Canada) and team found that although all participants showed poor affect recognition, there was no significant difference between patients who did and did not convert to full-blown psychosis regarding affect recognition.

Nevertheless, the authors comment that although poor affect recognition in CHR patients "does not independently predict conversion, it does relate to [poor] functioning, which in turn has been reported to predict conversion."

The researchers studied 172 patients who were aged an average of 19 years and at CHR for psychosis according to the Criteria of Prodromal Syndromes, along with 100 help-seeking individuals (HS).

Affect recognition was assessed at baseline using the Facial Emotion Identification Test (FEIT), the Facial Emotion Discrimination Test (FEDT), and a measure of affective prosody, and the participants were followed up for 24 months.

The researchers found that both CHR patients and HS individuals had poorer FEIT and FEDT scores than non-psychiatric controls from a previously published study, at 12.70 and 12.78 versus 12.32, and 25.73 and 25.44 versus 24.53, respectively.

CHR patients and HS individuals also had poorer affective prosody tests scores than those previously observed in non-psychiatric controls.

However, among the CHR patients, there were no significant differences between those who converted (n=25) and those who did not convert to psychosis on any of the three affect recognition tasks at baseline.

"Thus, our results suggest that poorer performance on social cognition may be indicative of being potentially vulnerable to developing psychosis but not necessarily a marker of developing a full blown psychotic illness," Addington and team conclude.

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