Identifying persistent negative symptoms in first episode psychosis

Hovington, Cindy L.; Bodnar, Michael; Joober, Ridha; Malla, Ashok; Lepage, Martín

doi:10.1186/1471-244x-12-224

Cited by 77 publications

(58 citation statements)

References 68 publications

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“…The percentages of patients with clinically significant negative symptoms at baseline ranged from substantial to very substantial: 25.8, 33%, and 71%, (Chang et al, 2011; Evensen et al, 2012; Galderisi et al, 2013), respectively. Prevalence rates of negative symptoms at one-year and three-year follow-up varied: 6.7%, 23.7%, 27% (Chang et al, 2011; Galderisi et al, 2013; Hovington et al, 2012). These studies also suggest that early negative symptoms can persist, as they are present at subsequent follow-up points for up to 10 years (Evensen et al, 2012) and might become more prevalent over time (Chang et al, 2011).…”

Section: Introductionmentioning

confidence: 96%

Negative symptoms and functioning during the first year after a recent onset of schizophrenia and 8years later

Ventura¹,

Subotnik²,

Gitlin³

et al. 2015

Schizophrenia Research

125

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Background Understanding the longitudinal course of negative symptoms, especially in relationship to functioning, in the early phase of schizophrenia is crucial to developing intervention approaches. The course of negative symptoms and daily functioning was examined over a one-year period following a recent onset of schizophrenia and at an 8-year follow-up point. Methods The study included 149 recent-onset schizophrenia patients who had a mean age of 23.7 (SD=4.4) years and mean education of 12.9 (SD=2.2) years. Negative symptom (BPRS and SANS) and functional outcome (SCORS) assessments were conducted frequently by trained raters. Results After antipsychotic medication stabilization, negative symptoms during the first outpatient year were moderately stable (BPRS ICC=0.64 and SANS ICC=0.66). Despite this overall moderate stability, 24% of patients experienced at least one period of negative symptoms exacerbation. Furthermore, entry level of negative symptoms was significantly associated with poor social functioning (r =−.34, p < .01) and work/school functioning (r =−.25, p < .05) at 12 months, and with negative symptoms at the 8-year follow-up (r =.29, p <.05). Discussion Early negative symptoms are fairly stable during the first outpatient year, are predictors of daily functioning at 12 months, and predict negative symptoms 8 years later. Despite the high levels of stability, negative symptoms did fluctuate in a subsample of patients. These findings suggest that negative symptoms may be an important early course target for intervention aimed at promoting recovery.

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Section: Introductionmentioning

confidence: 96%

Negative symptoms and functioning during the first year after a recent onset of schizophrenia and 8years later

Ventura¹,

Subotnik²,

Gitlin³

et al. 2015

Schizophrenia Research

125

View full text Add to dashboard Cite

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“…The PNS approach focuses on negative symptoms that persist for at least 6 months after the first episode of psychosis, in the absence of prominent depressive symptoms and parkinsonism [12]. Existing research indicates that PNS are associated with male sex, unemployment at baseline, longer duration of untreated psychosis, poorer insight and poorer pre-morbid academic, social and cognitive functioning [13][14][15][16].…”

Section: Introductionmentioning

confidence: 98%

Neurobiological background of negative symptoms

Galderisi

Merlotti

Mucci

2015

Eur Arch Psychiatry Clin Neurosci

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Studies investigating neurobiological bases of negative symptoms of schizophrenia failed to provide consistent findings, possibly due to the heterogeneity of this psychopathological construct. We tried to review the findings published to date investigating neurobiological abnormalities after reducing the heterogeneity of the negative symptoms construct. The literature in electronic databases as well as citations and major articles are reviewed with respect to the phenomenology, pathology, genetics and neurobiology of schizophrenia. We searched PubMed with the keywords "negative symptoms," "deficit schizophrenia," "persistent negative symptoms," "neurotransmissions," "neuroimaging" and "genetic." Additional articles were identified by manually checking the reference lists of the relevant publications. Publications in English were considered, and unpublished studies, conference abstracts and poster presentations were not included. Structural and functional imaging studies addressed the issue of neurobiological background of negative symptoms from several perspectives (considering them as a unitary construct, focusing on primary and/or persistent negative symptoms and, more recently, clustering them into factors), but produced discrepant findings. The examined studies provided evidence suggesting that even primary and persistent negative symptoms include different psychopathological constructs, probably reflecting the dysfunction of different neurobiological substrates. Furthermore, they suggest that complex alterations in multiple neurotransmitter systems and genetic variants might influence the expression of negative symptoms in schizophrenia. On the whole, the reviewed findings, representing the distillation of a large body of disparate data, suggest that further deconstruction of negative symptomatology into more elementary components is needed to gain insight into underlying neurobiological mechanisms.

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“…A study by Makinen (2010) [27], in a ten-year follow-up of FEP reported that 41% of the subjects had negative symptoms at the first episode, 39% in the follow-up phase, and 24% of subjects have persistent symptoms after 10 years. Another study reported the presence of persistent negative symptoms in about 27% of FEP patients with both affective and nonaffective psychosis [28]. Similarly, , reported that in a total of 1452 patients (60.6% male), one or more negative symptom was present in 57.6% of patients, with primary negative symptoms in 12.9% of subjects [29].…”

Section: Discussionmentioning

confidence: 99%

Study of negatives symptoms in first episode schizophrenia

Bambole¹,

Shah²,

Sonavane³

et al. 2013

OJPsych

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Background: Prevalence of negative symptoms in the early phase of schizophrenia remains uncertain. Negative symptoms are the primary cause of long term disability and poor functional outcome. The purpose of this study is to examine the presence of negative symptoms in patients with fist episode psychosis in schizophrenia who were hospitalized. Methods: Negative symptoms were measured in 72 patients presenting with FEP using the scale for assessment of negative symptoms (SANS) and ascertained diagnosis using DSM-IV. Prevalence of SANS items and subscales were examined for both schizophrenia and bipolar disorder. Results: This study shows that a significant number of patients with first episode schizophrenia had negative symptoms 66 (87.5%). All five subtypes of negative symptoms were present in 47% of patients suggesting primary negative symptoms, and about 40% have secondary negative symptoms. Independently, each subtype of negative symptoms was seen in 48% -76% of patients. The most prevalent negative symptom in first-episode schizophrenia was found to be blunting (72%). 46% of patients had significant level of depression, overall psychopathology was severe and level of functioning was poor. We found that 45.8% patients were prescribed anticholinergic medications which indicated that at least 45% subjects had extra-pyramidal symptoms (EPS). Conclusion: Primary negative symptoms are prevalent in about half of First episode Psychosis (FEP) schizophrenia patients. These findings have implications for identification, early treatment, and reduced treatment resistance for negative symptoms in order to increase social and clinical outcome of schizophrenia. Further research is required in this area.

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Identifying persistent negative symptoms in first episode psychosis

Cited by 77 publications

References 68 publications

Negative symptoms and functioning during the first year after a recent onset of schizophrenia and 8years later

Negative symptoms and functioning during the first year after a recent onset of schizophrenia and 8years later

Neurobiological background of negative symptoms

Study of negatives symptoms in first episode schizophrenia

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