Which features are associated with worse prognosis?

Which features are associated with worse prognosis?

• A. Predominant positive symptoms with good functioning
• B. Intact cognitive function
• C. More prominent negative symptoms, cognitive impairment, and worse functional outcomes
• D. Early treatment with antipsychotics

Answer: (C)

The key idea is that prognosis in psychotic disorders is more strongly affected by negative symptoms and cognitive impairment than by positive symptoms alone. Negative symptoms—such as lack of motivation, reduced speech, social withdrawal, and flattening of affect—along with cognitive deficits (problems with memory, attention, and executive function) are closely linked to poorer real-world functioning and longer-term disability. When these features are prominent, daily living, work, and social outcomes tend to worsen, making the overall prognosis worse. Early treatment with antipsychotics generally improves outcomes by shortening the duration of untreated psychosis and helping to control symptoms, especially positive ones. Intact cognitive function and predominantly positive symptoms with relatively preserved functioning are typically associated with a better prognosis, not a worse one. So the option describing more prominent negative symptoms, cognitive impairment, and worse functional outcomes best reflects a worse prognosis, aligning with the evidence that cognitive and negative symptom burden drives poorer long-term functioning.

The key idea is that prognosis in psychotic disorders is more strongly affected by negative symptoms and cognitive impairment than by positive symptoms alone. Negative symptoms—such as lack of motivation, reduced speech, social withdrawal, and flattening of affect—along with cognitive deficits (problems with memory, attention, and executive function) are closely linked to poorer real-world functioning and longer-term disability. When these features are prominent, daily living, work, and social outcomes tend to worsen, making the overall prognosis worse.

Early treatment with antipsychotics generally improves outcomes by shortening the duration of untreated psychosis and helping to control symptoms, especially positive ones. Intact cognitive function and predominantly positive symptoms with relatively preserved functioning are typically associated with a better prognosis, not a worse one.

So the option describing more prominent negative symptoms, cognitive impairment, and worse functional outcomes best reflects a worse prognosis, aligning with the evidence that cognitive and negative symptom burden drives poorer long-term functioning.