The clinical relevance of formal thought disorder in the early stages of psychosis: results from the PRONIA study


Background: Formal thought disorder (FTD) has been associated with more severe illness courses and functional deficits in patients with psychotic disorders. However, it remains unclear whether the presence of FTD characterises a specific subgroup of patients showing more prominent illness severity, neurocognitive and functional impairments. This study aimed to identify stable and generalizable FTD-subgroups of patients with recent-onset psychosis (ROP) by applying a comprehensive data-driven clustering approach and to test the validity of these subgroups by assessing associations between this FTD-related stratification, social and occupational functioning, and neurocognition. Methods: 279 patients with ROP were recruited as part of the multi-site European PRONIA study (Personalised Prognostic Tools for Early Psychosis Management; Five FTD-related symptoms (conceptual disorganization, poverty of content of speech, difficulty in abstract thinking, increased latency of response and poverty of speech) were assessed with Positive and Negative Symptom Scale (PANSS) and the Scale for the Assessment of Negative Symptoms (SANS). Results: The results with two patient subgroups showing different levels of FTD were the most stable and generalizable clustering solution (predicted clustering strength value = 0.86). FTD-High subgroup had lower scores in social (p fdr < 0.001) and role (p fdr < 0.001) functioning, as well as worse neurocognitive performance in semantic (p fdr < 0.001) and phonological verbal fluency (p fdr < 0.001), short-term verbal memory (p fdr = 0.002) and abstract thinking (p fdr = 0.010), in comparison to FTD-Low group. Conclusions: Clustering techniques allowed us to identify patients with more pronounced FTD showing more severe deficits in functioning and neurocognition, thus suggesting that FTD may be a relevant marker of illness severity in the early psychosis pathway.

Publication DOI:
Divisions: College of Health & Life Sciences > School of Psychology
College of Health & Life Sciences > Aston Institute of Health & Neurodevelopment (AIHN)
College of Health & Life Sciences
Additional Information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit Funding: Structural European Funding of the Italian Minister of Education (Attraction and International Mobility—AIM—action, grant agreement No 1859959
Uncontrolled Keywords: Clustering,Early psychosis,Formal thought disorder,Functioning,Neurocognition,Psychiatry and Mental health,Biological Psychiatry,Pharmacology (medical)
Publication ISSN: 1433-8491
Last Modified: 14 May 2024 16:23
Date Deposited: 04 Oct 2021 08:22
Full Text Link:
Related URLs: https://link.sp ... 406-021-01327-y (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2021-09-17
Published Online Date: 2021-09-17
Accepted Date: 2021-08-27
Submitted Date: 2021-05-01
Authors: Oeztuerk, Oemer Faruk
Pigoni, Alessandro
Wenzel, Julian
Haas, Shalaila S
Popovic, David
Ruef, Anne
Dwyer, Dominic B
Kambeitz-Ilankovic, Lana
Ruhrmann, Stephan
Chisholm, Katharine (ORCID Profile 0000-0002-0575-0789)
Lalousis, Paris
Griffiths, Sian Lowri
Lichtenstein, Theresa
Rosen, Marlene
Kambeitz, Joseph
Schultze-Lutter, Frauke
Liddle, Peter
Upthegrove, Rachel
Salokangas, Raimo K R
Pantelis, Christos
Meisenzahl, Eva
Wood, Stephen J
Brambilla, Paolo
Borgwardt, Stefan
Falkai, Peter
Antonucci, Linda A
Koutsouleris, Nikolaos
, PRONIA Consortium



Version: Published Version

License: Creative Commons Attribution

| Preview

Export / Share Citation


Additional statistics for this record