Impact of Negative Symptoms on Functioning and Quality of Life in First Psychotic Episodes of Schizophrenia

Abstract

Negative symptoms are not considered a unitary construct encompassing two different domains, diminished expression, and avolition-apathy. The aim of this study was to explore the relationships between each domain and psychosocial functioning and quality of life in people with a first psychotic episode of schizophrenia. In total, 61 outpatients were assessed with the Clinical Assessment Interview for Negative Symptoms (CAINS), The Functioning Assesment Short Test (FAST) and The Quality of Life Scale (QLS). The mean global score for CAINS was 21.5 (SD: 15.6), with a CAINS Avolition-Apathy (MAP) score of 17.0 (SD: 11.8), and CAINS Diminished Expression (EXP) score of 4.5 (SD: 5.0). The mean FAST score was 31.9 (SD: 18.9), and 41.1 (SD: 17.9) for QLS. Linear regression analysis revealed a significant (F(4,53) = 15.65, p < 0.001) relationship between MAP and EXP CAINS’ score and FAST score. CAINS-MAP was more predictive of FAST scores (β = 0.44, p = 0.001) than CAINS-EXP (β = 0.37, p = 0.007). Linear regression analysis for QLS revealed a significant model (F(4,56) = 29.29, p < 0.001). The standardized regression weight for the CAINS-MAP was around three times greater (β = −0.63, p < 0.001) than for CAINS-EXP (β = −0.24, p = 0.024). The two different domains are associated differently with functionality and quality of life.

Impact of negative symptoms on health-related quality of life in schizophrenia

“…This is consistent with what we found, although we looked at HRQoL rather than SQOL. While we did not find a significant relationship between EE and QoL, García et al (2022) found both MAP and EE assessed through Clinical Assessment Interview for Negative Symptoms (CAINS) to be negatively associated with QoL assessed on the Quality of Life Scale (QLS) ( 15 ). Nonetheless, MAP was reported to have a stronger association with QoL when compared to EE ( 15 ).…”

“…While studies have adopted different measures, no specific HRQoL instrument has been validated for use in negative symptoms ( 14 ). Evidence regarding association of NS dimensions with HRQoL is limited, with a few studies previously suggesting a negative association between MAP and HRQoL ( 15 , 16 ). However, no prior study has looked into contributions of the five NS domains on HRQoL ( 16 ).…”

The management of patients with predominant negative symptoms in Slovakia: A 1-year longitudinal, prospective & multicentric cohort study

“…Negative symptoms are well-known to affect daily functioning and quality of life (QoL) immensely [7,[10][11][12]. For instance, in a 3-year study with 17,384 outpatients from 37 countries, QoL was found to correlate with negative symptoms more than with positive symptoms [12].…”

Relationships between the pharmacological treatment method and negative symptoms, depression, social functioning and quality of life in schizophrenia patients during 11–15 years after a first psychiatric hospitalisation

“…However, regardless of the type of negative symptoms, it is important to identify their presence and to treat them appropriately if they are severe (Correll and Schooler, 2021). This is all the more important because increased negative symptoms, especially when they are persistent, have an adverse impact on the patient's daily functioning, social relationships, occupational activities, and quality of life for both themselves and their immediate family (GarcíaFernández et al, 2022;Siegrist et al, 2015).…”