The present review aims to identify correlations between negative symptoms (NS) and deficits in neurocognition and social cognition in subjects with first-episode psychosis (FEP) and at-high-risk populations (HR). A systematic search of the literature published between 1 January 2005 and 31 December 2022 was conducted on PubMed, Scopus, and PsycInfo. Out of the 4599 records identified, a total of 32 studies met our inclusion/exclusion criteria. Data on a total of 3086 FEP and 1732 HR were collected. The available evidence shows that NS correlate with executive functioning and theory of mind deficits in FEP subjects, and with deficits in the processing speed, attention and vigilance, and working memory in HR subjects. Visual learning and memory do not correlate with NS in either FEP or HR subjects. More inconsistent findings were retrieved in relation to other cognitive domains in both samples. The available evidence is limited by sample and methodological heterogeneity across studies and was rated as poor or average quality for the majority of included studies in both FEP and CHR populations. Further research based on shared definitions of first-episode psychosis and at-risk states, as well as on more recent conceptualizations of negative symptoms and cognitive impairment, is highly needed.

Objective: Sexual dimorphism has been investigated in schizophrenia, although sex-specific differences among individuals who are at clinical high-risk (CHR) for developing psychosis have been inconclusive. This study aims to characterize sexual dimorphism of language areas in the brain by investigating the asymmetry of four white matter tracts relevant to verbal working memory in CHR patients compared to healthy controls (HC). HC typically show a leftward asymmetry of these tracts. Moreover, structural abnormalities in asymmetry and verbal working memory dysfunctions have been associated with neurodevelopmental abnormalities and are considered core features of schizophrenia. Methods: Twenty-nine subjects with CHR (17 female/12 male) for developing psychosis and twenty-one HC (11 female/10 male) matched for age, sex, and education were included in the study. Two-tensor unscented Kalman filter tractography, followed by an automated, atlas-guided fiber clustering approach, were used to identify four fiber tracts related to verbal working memory: the superior longitudinal fasciculi (SLF) I, II and III, and the superior occipitofrontal fasciculus (SOFF). Using fractional anisotropy (FA) of tissue as the primary measure, we calculated the laterality index for each tract. Results: There was a significantly greater right>left asymmetry of the SLF-III in CHR females compared to HC females, but no hemispheric difference between CHR vs. HC males. Moreover, the laterality index of SLF-III for CHR females correlated negatively with Backward Digit Span performance, suggesting a greater rightward asymmetry was associated with poorer working memory functioning. Conclusion: This study suggests increased rightward asymmetry of the SLF-III in CHR females. This finding of sexual dimorphism in white matter asymmetry in a language-related area of the brain in CHR highlights the need for a deeper understanding of the role of sex in the high-risk state. Future work investigating early sex-specific pathophysiological mechanisms, may lead to the development of novel personalized treatment strategies aimed at preventing transition to a more chronic and difficult-to-treat disorder.

Psychotic-like experiences (PLEs) might occur in the general population as low-risk individual differences or prodromal features, requiring quick detection and early intervention. The aims of this study were to conduct a mini-systematic review of the prognostic abilities of the Prodromal Questionnaire-Brief (PQ-B), describe the PLEs distribution for the first time in a Polish population, assess PQ-B reliability and propose an innovative scoring approach based on cluster analysis.
Five hundred and twenty eight (334 female) adult volunteers underwent screening with the PQ-B, 49% also underwent the early psychosis screening test PRIME, to verify the tests\' psychometric properties, to compare the prognostic accuracy of the PQ-B to the more restrictive PRIME, and to the detected types of possible diagnosis in the general population.
Almost 70% of respondents met the prognostic criteria of the PQ-B while only 30.6% met the PRIME criteria. Both tests proved reliable (α > .835) and valid (rho >.710; P < .001). A cluster analysis identified three different sub-groups detected with the PQ-B: healthy individuals without PLE; healthy with low-distressing PLEs; and possibly prodromal subjects reporting less frequent but more distressing PLEs and no worries about their own mental state. Also in systematic reviews, authors of different adaptations have observed that the PQ-B has too low specificity and postulated the need for higher cut-offs.
Study provides evidence of good reliability and sensitivity of the PQ-B in assessing PLEs among the general population, but emphasizes that straightforward quantitative scoring criteria are still unclear. A more qualitative approach might be useful for differentiating true prodromal subjects from clinically low-risk individual differences.