The primary and enduring presence of negative symptoms observed in a relatively homogeneous subgroup of patients with schizophrenia led to the concept of deficit syndrome (DS). Until date, it is considered that 20–25% of schizophrenia cohorts have DS. The aim of this meta-analysis was to determine the current prevalence of DS, including international and most recent studies. Thirteen observational studies met the inclusion criteria, comprising 2092 patients from eight countries. Pooled proportion of the DS subgroup was 32.64%, higher than previously reported. Based on our outcomes, up to one-third of patients with schizophrenia might have idiopathic and stable negative symptoms. This significant proportion of patients should be well represented in clinical trial's samples.
The prognostic role of catatonia, hallucinations, and symptoms of schizophrenia in acute and transient psychosis L opez-D ıaz A, Fern andez-Gonz alez JL, Lara I, Crespo-Facorro B, Ruiz-Veguilla M. The prognostic role of catatonia, hallucinations, and symptoms of schizophrenia in acute and transient psychosis.Objectives: To examine the prospective temporal stability of acute and transient psychotic disorders (ATPDs) and analyze whether there are clinical, psychopathological, or sociodemographic characteristics that predict ATPD diagnostic stability. Method: We conducted a prospective, 2-year, observational study of patients presenting a first-episode ATPD. A multivariate logistic regression model was developed to identify independent variables associated with ATPD diagnostic stability. Well-established predictive factors of diagnostic stability, as well as all the psychopathological features included in the ICD-10 Diagnostic Criteria for Research (DCR) descriptions of ATPD, were analyzed. Results: Sixty-eight patients with a first episode of ATPD completed the study with a diagnostic stability rate as high as 55.9% (n = 38) at the end of the follow-up period. Multivariate analysis revealed that diagnostic stability was independently significantly associated with the baseline presence of motility disturbances (OR = 6.86, 95% CI = 1.10-42.62; P = 0.039), the absence of hallucinations (OR = 5.75, 95% CI = 1.51-21.98; P = 0.010), and the absence of schizophrenic features (OR = 7.13, 95% CI = 1.38-36.90; P = 0.019). Conclusion: A symptom checklist assessing these psychopathological features would enable early identification of those subjects whose initial ATPD diagnosis will remain stable over time.
Significant outcomes• The ATPD stability rate in our sample was moderate and as high as 55.9%. • ATPD diagnostic stability was independently significantly associated with the baseline presence of motility disturbances.• Diagnostic shifts were independently significantly associated with hallucinations and schizophrenia symptoms at the onset of ATPD. Limitations • Our small sample size and relatively short length of our follow-up compared to other large-scale epidemiological studies.• The lack of standardized psychometric assessment scales for measuring the severity of baseline ATPD psychotic symptomatology.• This study did not analyze the prognostic role of antipsychotic maintenance treatment or the impact of psychotic relapse.
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