The Neurobiology of Negative Symptoms and the Deficit Syndrome

2009 ◽  
pp. 505-523
Author(s):  
B. A. Fischer ◽  
B. Kirkpatrick ◽  
W. T. Carpenter
Keyword(s):  
Negative Symptoms ◽  
Deficit Syndrome

scholarly journals In Schizophrenia, Increased Plasma Igm/Iga Responses to Gut Commensal Bacteria are Associated with Negative Symptoms, Neurocognitive Impairments and the Deficit Phenotype

2018 ◽  
Author(s):  
Michael Maes ◽  
Buranee Kanchanatawan ◽  
Sunee Sirivichayakul ◽  
Andre F. Carvalho
Keyword(s):  
Azelaic Acid ◽  
Negative Symptoms ◽  
Commensal Bacteria ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Deficit Syndrome ◽  
Igm Antibodies ◽  
Deficit Schizophrenia ◽  
Neurocognitive Impairments ◽  
Natural Igm

Increased gut permeability (leaky gut) with increased translocation of Gram-negative bacteria plays a role in the gut-brain axis through effects on systemic immune-inflammatory processes. Deficit schizophrenia is characterized by an immune-inflammatory response combined with a deficit in natural IgM antibodies to oxidative specific epitopes (OSEs), which are a first line defense against bacterial infections. This study measured plasma IgA/IgM responses to 5 Gram-negative bacteria in association with IgM responses to malondialdehyde (MDA) and azelaic acid in 80 schizophrenia patients (40 with the deficit syndrome and 40 without) and in 38 healthy controls.Deficit schizophrenia was characterized by significantly increased IgA responses to Hafnei alvei, Pseudomonas aeruginosa, Morganella morganii and Klebsiella pneumoniae as compared with non-deficit schizophrenia. The presence of deficit schizophrenia was highly predicted by increased IgA responses to Pseudomonas putida and IgM responses to all 5 Gram-negative bacteria and lowered natural IgM to MDA and azelaic acid with a bootstrap area under the ROC curve of 0.960 (2000 random curves). A large proportion of the variance (41.5%) in the PANSS negative score was explained by the regression on IgA responses to K. pneumoniae and IgM responses to the 5 enterobacteria coupled with lowered IgM antibodies to azelaic acid. There were significant associations between IgA levels to Gram-negative bacteria and Mini Mental State Examination, Boston naming test, Verbal Fluency and Word List Memory test scores.These findings provide further evidence that deficit schizophrenia is a distinct phenotype of schizophrenia, which is characterized by an increased impact of Gram-negative commensal bacteria coupled with a deficit in natural IgM, pointing to aberrations in B1 cells. It is concluded that increased bacterial translocation and deficits in the compensatory immune-regulatory system (CIRS) may drive negative symptoms and neurocognitive impairments, which are hallmarks of deficit schizophrenia.

Systematic Review of Local Studies Regarding Efficiency of Add-On Medications on Negative Symptoms of Schizophrenia: A Meta-Analysis

2019 ◽  
Vol 8 (2) ◽  
pp. 113-122
Author(s):  
Saeed Shoja Shafti
Keyword(s):  
Effect Size ◽  
Psychotropic Drugs ◽  
Negative Symptoms ◽  
Meta Analysis ◽  
Combined Effect ◽  
Placebo Control ◽  
Double Blind ◽  
Deficit Syndrome ◽  
Text Revision ◽  
Diagnostic And Statistical Manual

Background: While negative symptoms are connected with poor functioning and quality of life, pharmacological managements have imperfect effects on deficit syndrome and may even subsidize or aggravate secondary negative symptoms. Meanwhile, management of negative symptoms by means of add-on medications has resulted in instable consequences. Objective: In the current tryout, some of the indigenous systematic issued studies have been the theme of a new meta-analysis, to assess the effectiveness of adjunctive psychotropic drugs on deficit syndrome of schizophrenia. Methods: Twelve randomized placebo-control trials (n=433), which had been implemented in Razi psychiatric hospital in the last 14 years, had been selected for the present analysis. As a shared protocol, all cases had been selected amongst the male inpatients, who were hospitalized in chronic section of the hospice and had been diagnosed schizophrenia in line with “Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision”. In this regard, the aforesaid samples had been entered into matching-group, double-blind assessments for random assignment to a psychotropic medication (like antidepressant, benzodiazepine, psycho-stimulant, Acetyl-cholinesterase inhibitors) or placebo in addition to their current drug. In these trials, “Scale for Assessment of Negative Symptoms (SANS)” had been used as the main outcome measure for evaluation of negative symptoms. Also, response was defined as a decrease in >20% in the severity of SANS score (over-all and/or sub-scales). Results: While the heterogeneity of the present meta-analysis was intermediate, the “Combined Effect Size” of the aforesaid assessments has revealed a significant influence respecting efficiency of psychotropic drugs on negative symptoms of schizophrenia (OR = 5.40, CI=2.69- 10.85, z= 5.32, p<0.000). Similar results, as well, could be found in connection with various negative symptoms. In this regard, ‘Anhedonia-Asociality’ showed the best “Combined Effect Size”, afterwards “Affective Blunting”, “Avolitio -Apathy”, “Attention Deficit”, and last of all “Alogia”. “Heterogeneity” of all said analysis was insignificant and therefore appropriate. Conclusion: According to the findings, psychotropic drugs, as add-on medications, have valuable influence in regard to amelioration of negative symptoms of schizophrenia.

The deficit syndrome in first-admission patients with psychotic and non-psychotic disorders

1997 ◽  
Vol 12 (2) ◽  
pp. 53-57 ◽  
Author(s):  
H Gerbaldo ◽  
K Georgi ◽  
D Pieschl
Keyword(s):  
Negative Symptom ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Deficit Syndrome ◽  
Schizophrenic Patients ◽  
First Admission

SummaryThe authors study the frequency of primary enduring negative symptoms in first-admission patients with schizophrenic and non-schizophrenic disorders. Carpenter's criteria for distinguishing the primary, enduring negative symptoms from the more transient negative symptoms (secondary to different factors) were applied. Furthermore, they compare negative symptom complexes between first-admission patients and patients with recurrent hospitalizations (within 5 years after first admission). There was a trend for patients with recurrent admissions to show more frequently a deficit syndrome than first-admission patients. Nevertheless, this difference was not significant (χ2 = 0.90). First-admission patients with deficit syndrome had significantly higher affective blunting (P < 0.05) and anhedonia (P < 0.001) than those with recurrent admissions. First-admission subjects with psychotic disorders had significantly higher frequency of deficit syndrome than those first-admission patients with non-psychotic disorders (P < 0.05). These results show that negative symptoms observed in first-admitted non-schizophrenic patients can also be enduring and primary. Thereby this work does not contribute to support the specificity of primary enduring negative symptoms for schizophrenia. Moreover, data suggest, that primary anhedonia and affective blunting can decrease within the first 5 years after discharge.

scholarly journals Executive functioning and psychopathological profile in relatives of individuals with deficitv.non-deficit schizophrenia: a pilot study

2013 ◽  
Vol 23 (1) ◽  
pp. 85-97 ◽  
Author(s):  
S. Scala ◽  
A. Lasalvia ◽  
L. J. Seidman ◽  
D. Cristofalo ◽  
C. Bonetto ◽  
...  
Keyword(s):  
Executive Functioning ◽  
Negative Symptoms ◽  
Neuropsychological Functioning ◽  
Executive Dysfunction ◽  
Wisconsin Card Sorting Test ◽  
Card Sorting ◽  
Neurocognitive Deficits ◽  
Paranoid Ideation ◽  
Deficit Syndrome ◽  
First Degree Relatives

Aims.Heterogeneity of schizophrenia is known to be reflected in neuropsychological functioning of patients, but its expression in relatives is understudied. This study aims at exploring relationship between executive functioning and clinical profiles of first-degree relatives of patients who are classified as having or not having the deficit subtype of schizophrenia (DSRELsv.non-DSRELs), with the prediction of greater executive impairment in DSRELs.Methods.DSRELs (n = 15) and non-DSRELs (n = 40) were compared with community controls (CCs,n = 55) on executive functioning measured by the Wisconsin Card Sorting Test (WCST) and the phonemic verbal fluency (PVF), and clinical measures. Effects of psychopathology and intelligence quotient (IQ) measures were investigated to determine their association with executive performance.Results.DSRELs showed more executive dysfunction on WCST and poorer social functioning than CCs and more severe negative symptoms than non-DSRELs. Differences on WCST-categories achieved (WCST-CA) remained significant after adjustment for clinical confounders and IQ. WCST-CA was associated with apathy and paranoid ideation only within the DSREL subgroup.Conclusions.Executive functioning and negative symptoms are severely impaired in first-degree relatives of deficit syndrome patients, thus suggesting that some neurocognitive deficits in patients may be transmitted within families according to the pathophysiology of the probands.

3-dimensional evaluation of lateral ventricle volumes of schizophrenia patients and investigation of the subgroups

2016 ◽  
Vol 33 (S1) ◽  
pp. S199-S199
Author(s):  
I. Polat Nazli ◽  
M. Atlamaz ◽  
O. Ozalay ◽  
F. Deger ◽  
O. Kitis ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Negative Symptoms ◽  
Pearson Correlation ◽  
Imaging Data ◽  
Total Brain Volume ◽  
Deficit Syndrome ◽  
3 Dimensional ◽  
Significant Difference ◽  
Competing Interest ◽  
Lv Volume

IntroductionThe thought of greater loss of brain tissue in Deficit Syndrome (DS) i.e. subgroup of schizophrenia with enduring primary negative symptoms defined by Carpenter et al.; this has not been verified by recent studies.ObjectiveAccumulated researches suggest that enlargement in Lateral Ventricles (LV) is related with current negative symptoms and poor prognosis. However, this has not been validated in DS.AimsOur aim is to study the association between the enduring negative symptoms and LV changes schizophrenia. We included both deficit and non-deficit patients for comparison with controls.MethodsForty-five patients (18 DS, 27 non-DS) and 37 healthy controls were recruited, evaluated for positive and negative symptoms, depression and extrapyramidal symptoms. Structural magnetic resonance imaging was performed. LV was assessed by MANCOVA (gender, age total brain volume as confounding factors) in 3-dimensional (3D) shape analyses. Correlations between clinical and imaging data were analyzed by Pearson correlation coefficient; P > 0.05 being significant.ResultsLV of patients was found to be greater than controls, especially in regions adjacent to parietal and temporal regions but no significant difference between subgroups was detected. Enlargement in right LV by corpus callosum adjacency was found in DS. There was no correlation between negative symptoms and LV volume.ConclusionsThe idea of greater amount of LV enlargement in patients with predominant negative symptoms could not be observed in 3D analyses. New pathophysiological theories are needed for the explanation of negative symptoms, loss of functioning and poor prognosis rather than only commenting about tissue decrease/loss.Disclosure of interestThe authors have not supplied their declaration of competing interest.

VTA-insula Connectivity and Avolition in Subjects with Schizophrenia

2017 ◽  
Vol 41 (S1) ◽  
pp. S57-S57
Author(s):  
A. Mucci ◽  
G.M. Giordano ◽  
M. Stanziano ◽  
M. Papa ◽  
S. Galderisi
Keyword(s):  
Negative Symptoms ◽  
Occipital Cortex ◽  
Advisory Board ◽  
Strong Impact ◽  
Seed Region ◽  
Resting State Functional Connectivity ◽  
Potential Conflict ◽  
Deficit Syndrome ◽  
Dopamine Circuits ◽  
The Right

IntroductionAvolition represents an important domain of negative symptoms in schizophrenia with a strong impact on functional outcome. Primary and persistent avolition is refractory to available pharmacological and psychological treatments. A better understanding of its pathophysiological mechanisms is fundamental to promote development of new treatments. Recent models of avolition converge on dopaminergic circuits involved in motivation and its translation in goal-directed behavior. Deficits in task-related activation or connectivity within mesolimbic and mesocortical dopamine circuits were reported in schizophrenia but the relationship with avolition was not fully established.AimsThe present study aimed to investigate resting-state functional connectivity (RS-FC) within the motivation circuits in schizophrenia patients and its relationships with primary and persistent avolition.MethodsRS-FC, using VTA as a seed region, was investigated in 22 healthy controls (HC) and in 26 schizophrenia patients (SCZ) divided in high (HA) and low avolition (LA) subgroups. Avolition was assessed using the Schedule for the Deficit Syndrome.ResultsHA, in comparison to LA and HC, showed significantly reduced RS-FC with the right ventrolateral prefrontal cortex (R-VLPFC), right insula (R-INS) and right lateral occipital cortex (R-LOC). The RS-FC of these regions was negatively correlated to avolition.ConclusionsOur findings demonstrate that avolition in schizophrenia is linked to dysconnection of VTA from key cortical regions involved in retrieval of outcome values of instrumental actions to motivate behavior.Disclosure of interestAM received honoraria or advisory board/consulting fees from the following companies: Janssen Pharmaceuticals, Otsuka, Pfizer and Pierre Fabre. SG received honoraria or advisory board/consulting fees from the following companies: Lundbeck, Janssen Pharmaceuticals, Hoffman-La Roche, Angelini-Acraf, Otsuka, Pierre Fabre and Gedeon-Richter. All other Authors declare no potential conflict of interest.

Positive and negative symptoms/syndromes in schizophrenia: reliability and validity of different diagnostic systems

1995 ◽  
Vol 25 (1) ◽  
pp. 43-50 ◽  
Author(s):  
V. Peralta ◽  
M. J. Cuesta ◽  
J. De Leon
Keyword(s):  
Internal Consistency ◽  
Negative Symptom ◽  
Social Adjustment ◽  
Negative Symptoms ◽  
Rating Scales ◽  
Reliability And Validity ◽  
Poor Response ◽  
Diagnostic Systems ◽  
Deficit Syndrome ◽  
Positive And Negative Symptoms

SynopsisThe paper explores the reliability, concurrent validity and overlap of some positive/negative symptom rating scales and typological criteria in 100 schizophrenic patients. Rating scales include Andreasen's Scales for the Assessment of Positive and Negative Symptoms, Abrams and Taylor's Scale for Emotional Blunting, and Kay's Positive and Negative Syndrome Scale. Criteria for categorizing individual patients include Andreasen's and Kay's criteria for positive and negative types of schizophrenia as well as Carpenter's criteria for the deficit syndrome. The correlations among positive as well as among negative scales were high. The agreement among criteria tended to be lower. Both positive scales showed low internal consistency. Kay's negative scale had the greatest internal consistency, which suggests that it is measuring a homogeneous syndrome. All negative symptom scales and categorical syndromes identified a group of patients who were single and exhibited schizoid or schizotypal pre-morbid personality disorders, poor premorbid sexual/social adjustment, poor response to neuroleptics and poor prognosis.

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