Olfactory Identification Deficits in First-Episode Psychosis May Predict Patients at Risk for Persistent Negative and Disorganized or Cognitive Symptoms

Objective: One-third of patients with a schizophrenia spectrum disorder have a measurable olfactory identification deficit at first examination. The authors studied the relationship of this deficit to symptom remission after 1 year of treatment. Method: Fifty-eight patients naive to antipsychotic medication who entered the Nova Scotia Early Psychosis Program were symptomatically rated with the Positive and Negative Syndrome Scale (PANSS) (at baseline and 1 year). At baseline, the University of Pennsylvania Smell Identification Test (UPSIT) was also completed. Remission was determined for four symptom factors derived from the PANSS (positive, negative, cognitive disorganized, and anxiety depression). Patients with and without remission were compared on UPSIT scores. Results: Patients with nonremission of negative and cognitive disorganized symptoms had significantly lower baseline UPSIT scores compared with pateints with remission. UPSIT scores were unrelated to remission of positive or anxiety depression symptoms. Conclusions: UPSIT scores can be used to identify patients at risk for persistent negative and disorganized cognitive symptoms.