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Background Negative symptoms largely account for poor outcome in psychotic disorders but remain difficult to treat. A cognitive– behavioral approach to these symptoms showed promise in chronic schizophrenia patients. We explored whether a combination of group and individual treatment focused on social activation (CBTsa) could benefit patients recently diagnosed with a psychotic disorder. Methods A single-blind randomized controlled trial enrolled 99 participants recently diagnosed with schizophrenia or a related disorder that received treatment as usual (TAU; n 50), or TAU plus CBTsa (n 49). Negative symptoms (Brief Negative Symptom Scale) and social withdrawal (Positive and Negative Syndrome Scale) were primary outcomes. Secondary outcome measures included dysfunctional beliefs (Dysfunctional Attitudes Scale-Defeatist Performance Attitude), stigma (ISMIS), and symptom severity and functioning as measured with the Global Assessment of Functioning (GAF). Outcomes were compared directly posttreatment and at follow-up (6 months posttreatment). Results Intention-to-treat analyses showed significant improvement in GAF symptoms (p.02, d 0.36) and a decrease in negative symptoms on trend level (p.08, d 0.29) in CBTsa compared to TAU at posttreatment. These group differences were no longer apparent at 6 months follow-up. Social withdrawal and negative symptoms improved over time in both conditions. Conclusions The current trial showed small positive effects on symptom severity posttreatment but did not demonstrate maintenance of longer-term effects in favor of the CBTsa group. Findings suggest that the treatment duration may have been too short to change dysfunctional beliefs, a potentially important maintaining factor of negative symptom severity. Longer intervention periods in later, more stable stages of the illness when intensive standard treatment has tapered off may yield more beneficial effects. [ABSTRACT FROM AUTHOR]

Background Autism traits are present at elevated rates in individuals with psychotic disorders (PD). However, prevalence varies across clinical samples and it is unclear whether individuals with a genetic risk for psychosis (GR) also report more symptoms. Furthermore, it is unknown to what extent comorbid autism symptoms may have an impact on social functioning in psychotic disorders. Methods A large sample of 504 individuals with a PD, 572 individuals with GR (siblings) and 337 typical comparison (TC) individuals was recruited. Autism traits were assessed with the Autism Spectrum Quotient (AQ) and social functioning was measured with the Social Functioning Scale. Results The proportion of AQ scores >32 (indicative of autism diagnosis) was 6.6% for PD, 1.1% for GR and 1.2% for TC. For AQ scores >26 (indicative of high autism traits) respective percentages were: 21.4%, 2.8% and 2.4%. Mean group differences for autism traits (PD > GR > TC) and social functioning (PD < GR < TC) were all significant, albeit with small effect sizes for GR vs TC. Within the PD and GR group, autistic traits showed a negative impact on overall social functioning above and beyond the effect of positive psychotic symptoms. Discussion At least 1 in 5 individuals with a psychotic disorder is characterized by elevated levels of autism traits. In addition, levels of social functioning are negatively affected by autisms traits in individuals with (a genetic predisposition to) psychotic disorders. These findings warrant specific clinical guidelines for psychotic patients who present themselves with autistic comorbidity. [ABSTRACT FROM AUTHOR]