Negative Symptoms: Getting to the Specifics
Negative symptoms, a core symptom domain in schizophrenia, are described as a lessening or absence of normal behaviors and functions related to either motivation and interest, or emotional expression.
Negative symptom dimensions | |
Primary | Cause factor: schizophrenia, core symptom |
Secondary | Cause factor: other symptoms of schizophrenia, depression, environment |
Prominent | Intensity factor: more negative symptoms than positive symptoms |
Predominant | Intensity factor: high level of negative symptoms, low positive symptoms |
Persistent | Time factor: present for more than 6 months โ 1 year |
References
- Mucci, A., Merlotti, E., รรงok, A., Aleman, A. & Galderisi, S. Primary and persistent negative symptoms: Concepts, assessments and neurobiological bases. Schizophr. Res. 186, 19โ28 (2017).
- Carpenter, W. T., Heinrichs, D. W. & Alphs, L. D. Treatment of negative symptoms. Schizophr. Bull. 11, 440โ452 (1985).
- Hasan, A. et al. World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Schizophrenia, Part 1: Update 2012 on the acute treatment of schizophrenia and the management of treatment resistance. World J. Biol. Psychiatry 13, 318โ378 (2012).
- Rabinowitz, J. et al. Negative symptoms in schizophrenia โ the remarkable impact of inclusion definitions in clinical trials and their consequences. Schizophr. Res. 150, 334โ338 (2013).
- European Medicines Agency. Guideline on clinical investigation of medicinal products, including depot preparation in the treatment of schizophrenia. (2012).
Markers of Inflammation and Infection in Schizophrenia
Molecular Psychiatry
Cerebrospinal fluid markers of inflammation and infections in schizophrenia and affective disorders: a systematic review and meta-analysis
The Challenge of Diagnosing Negative Symptoms
Primary and secondary negative symptoms may be the most important distinction in the negative symptom lexicon because of their different clinical implications.
References
- Kirkpatrick, B., Buchanan, R. W., Ross, D. E. & Carpenter, J. A separate disease within the syndrome of schizophrenia. Arch. Gen. Psychiatry 58, 165โ171 (2001).
- Galderisi, S., Mucci, A., Buchanan, R. W. & Arango, C. Negative symptoms of schizophrenia: new developments and unanswered research questions. The Lancet Psychiatry 5, 664โ677 (2018).
- Kirkpatrick, B., Fenton, W. S., Carpenter, W. T. & Marder, S. R. The NIMH-MATRICS consensus statement on negative symptoms. Schizophr. Bull. 32, 214โ219 (2006).
- Kirschner M. Schizophr Res. 2017;186:29-38.;
- Carpenter WT.ย Schizophrenia Bulletin 1985; 11:440-452;
- WFBSP. The World Journal of Biological Psychiatry 2012; 13: 318โ378
- Fervaha et al, Eur Psychiatry. 2014 Sep;29(7):449-55
- Bucci et al, Curr Opin Psychiatry. 2017 May;30(3):201-208
Selection of Schizophrenia Rating Scales
Rating scales help with monitoring the severity of symptoms in schizophrenia. Up until the 1980s, researchers focused on the positive symptoms, but later on they switched to both positive and negative symptoms.1
References
- Overall and Gorham. Psychological Reports. 1962;10:799-812
- Andreasen, University of Iowa, 1984
- Andreasen, University of Iowa, 1984
- Stanley et al. Schizophrenia Bulletin. 1987; 13(2):261โ276
- Hopkins et al. Schizophrenia Bulletin. 2018; 44(3): 593โ602
- Axelrod et al. Journal of Psychiatric Research. 1993; 27(3):253-258
- Morosini et al. Acta Psychiatr Scand. 2000;101(4):323-329
- Menezes et al. J Bras Psiquiatr. 2012;61(3):176-80
- Haro et al. Acta Psychiatr Scand Suppl. 2003;(416):16-23
- Kring et al. Am J Psychiatry. 2013;170:165โ172
- Llerena et al. Compr Psychiatry. 2013;54(5): 568โ574
The Burden of Schizophrenia
Despite being a disorder with relatively low prevalence, schizophrenia is ranked among the top 25 leading causes of disability1. Even with best practice treatment, outcomes are often suboptimal given the complexity of the disorder and its wide-ranging consequences.
References
- Millier, A. et al. Humanistic burden in schizophrenia: A literature review. J. Psychiatr. Res. 54, 85โ93 (2014).
- The National Alliance on Mental Illness. Schizophrenia: Public Attitudes, Personal Needs Views from People Living with Schizophrenia, Caregivers, and the General Public. (2008).
- Chong, H. Y. et al. Global economic burden of schizophrenia: A systematic review. Neuropsychiatr. Dis. Treat. 12, 357โ373 (2016).
- Whiteford HA. Et al. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet 2013;9;382(9904):1575-86
DEVELOPMENT AND PSYCHOPATHOLOGY
Childhood behaviour to predict psychosis-spectrum diagnoses in adulthood
NEWS IN TREATMENT OF SCHIZOPHRENIA
The goals of schizophrenia treatment differ according to the phase of illness. Early intervention is a key to more a favourable prognosis for patients since the
moreโฆTREATMENT OF NEGATIVE SYMPTOMS
Understanding the relationship between a symptom from a specific domain in schizophrenia and clinical outcomes is important because interventions that just focu
moreโฆ