The Differential Diagnosis of Negative Symptoms in Chronic Schizophrenia

1989 ◽  
Vol 23 (4) ◽  
pp. 491-496 ◽  
Author(s):  
Harvey A. Whiteford ◽  
Cecilia A. Peabody
Keyword(s):  
Differential Diagnosis ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Accurate Diagnosis ◽  
Paper Briefly ◽  
Schizophrenic Patients

Negative symptoms in schizophrenic patients can have many causes. This paper briefly reviews some of those factors which may contribute to negative symptoms apart from the schizophrenic illness itself. Making these distinctions is crucial for accurate diagnosis, management and prognosis.

Three Syndromes in Chronic Schizophrenia

1989 ◽  
Vol 155 (S7) ◽  
pp. 119-122 ◽  
Author(s):  
P.F. Liddle ◽  
Thomas R.E. Barnes ◽  
D. Morris ◽  
S. Haque
Keyword(s):  
Cognitive Impairment ◽  
Clinical Features ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Brain Abnormalities ◽  
Brain Abnormality ◽  
Schizophrenic Patients ◽  
Extensive Body ◽  
Positive And Negative Symptoms

In recent years, exploration of the distinction between positive and negative symptoms of schizophrenia has provided a fruitful basis for attempts to relate the clinical features of schizophrenia to the accumulating evidence of brain abnormalities in schizophrenic patients. By 1982, there was an extensive body of evidence supporting the hypothesis that negative schizophrenic symptoms, such as poverty of speech and flatness of affect, were associated with substantial brain abnormalities, such as increased ventricular to brain ratio, and extensive cognitive impairment (Crow, 1980; Andreasen & Olsen, 1982). However, at that stage there were several fundamental unanswered questions about the nature of negative symptoms, and their relationship to indices of brain abnormality. This paper presents some findings of a series of studies initiated in 1982 to seek answers to some of these questions.

Tardive Dyskinesia and Type II Schizophrenia

1992 ◽  
Vol 160 (2) ◽  
pp. 253-256 ◽  
Author(s):  
Elizabeth J. B. Davis ◽  
Milind Borde ◽  
L. N. Sharma
Keyword(s):  
Cognitive Impairment ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Thought Disorder ◽  
Control Group ◽  
Positive Symptoms ◽  
Type Ii ◽  
Formal Thought Disorder ◽  
Schizophrenic Patients ◽  
Male Patients

Cognitive impairment, negative and positive symptoms, primitive release reflexes, and age/temporal disorientation were assessed in 20 male patients meeting the DSM–III–R criteria for chronic schizophrenia and Schooler & Kane's criteria for TD. The control group comprised 20 age-matched male chronic schizophrenic patients without TD. Significant associations were found between TD, cognitive impairment, some negative symptoms, and formal thought disorder. These associations were independent of other illness and treatment variables. The severity of TD correlated significantly with that of cognitive impairment.

Late Onset Involuntary Movements in Chronic Schizophrenia: Relationship of ‘Tardive’ Dyskinesia to Intellectual Impairment and Negative Symptoms

1986 ◽  
Vol 149 (5) ◽  
pp. 616-620 ◽  
Author(s):  
J. L. Waddington ◽  
H. A. Youssef
Keyword(s):  
Tardive Dyskinesia ◽  
Negative Symptoms ◽  
Late Onset ◽  
Chronic Schizophrenia ◽  
Intellectual Impairment ◽  
Medication History ◽  
Involuntary Movements ◽  
Schizophrenic Patients ◽  
Relationship Of

Intellectual impairment, negative symptoms, and medication history were assessed in chronic schizophrenic patients with and without abnormal involuntary movements (tardive dyskinesia). Patients with involuntary movements had received neither longer nor more intensive treatment with neuroleptics or anticholinergics. However, the presence or absence of involuntary movements was prominently associated with the presence or absence of intellectual impairment/negative symptoms; these features are characteristic of the defect state/type II syndrome of schizophrenia, in which structural abnormalities of the brain may be over-represented. The role of subtle organic changes in conferring vulnerability to the emergence of such involuntary movements should be re-evaluated.

Two kinds of cognitive deficit associated with chronic schizophrenia

1977 ◽  
Vol 7 (1) ◽  
pp. 171-173 ◽  
Author(s):  
C. D. Frith
Keyword(s):  
Feature Selection ◽  
Negative Symptoms ◽  
Cognitive Deficit ◽  
Chronic Schizophrenia ◽  
Positive Symptoms ◽  
Chronic Schizophrenic ◽  
Normal Degree ◽  
Schizophrenic Patients

SynopsisThe performance of 21 chronic schizophrenic patients was investigated on two tests of feature selection. It was found that patients with negative symptoms (muteness, withdrawal, etc.) were characterized by an extreme lack of persistence, but selected usual features; whereas patients with positive symptoms (hallucinations, delusions, etc.) had a normal degree of persistence, but selected unusual features.

Efficacy of Adjunctive Carbamazepine in the Treatment of Chronic Schizophrenia

1987 ◽  
Vol 21 (4) ◽  
pp. 355-358 ◽  
Author(s):  
John M. Herrera ◽  
John J. Sramek ◽  
Jerome F. Costa
Keyword(s):  
Negative Symptoms ◽  
Antipsychotic Drugs ◽  
Treatment Resistance ◽  
Chronic Schizophrenia ◽  
Neuroleptic Drugs ◽  
Treatment Resistant ◽  
Blind Trial ◽  
Schizophrenic Patients ◽  
Single Blind ◽  
Single Blind Trial

Six treatment-resistant schizophrenic patients were given a ten-week single-blind trial of carbamazepine. Treatment resistance was determined on the basis of documented failure to respond to treatment with at least three neuroleptic drugs from two different chemical classes. The adjunctive use of carbamazepine resulted in a significant improvement of the negative symptoms of schizophrenia. These symptoms are often poorly responsive to conventional antipsychotic drugs. Therefore, controlled studies should be performed to further assess the possible efficacy of carbamazepine in schizophrenia.

Lateral ventricular size in schizophrenia: relationship to the disease process and its clinical manifestations

1985 ◽  
Vol 15 (1) ◽  
pp. 27-41 ◽  
Author(s):  
D. G. C. Owens ◽  
E. C. Johnstone ◽  
T. J. Crow ◽  
C. D. Frith ◽  
J. R. Jagoe ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Clinical Manifestations ◽  
Disease Process ◽  
Chronic Schizophrenia ◽  
Defect State ◽  
Large Sample Size ◽  
Ventricular Enlargement ◽  
Ventricular Size ◽  
Physical Treatment ◽  
Schizophrenic Patients

SynopsisUsing computed tomography, lateral ventricular size was studied in a sample of 112 institutionalized chronic schizophrenic patients (selected from 510 cases to investigate the correlates of the defect state and intellectual decline and the effects of insulin, electroconvulsive and neuroleptic treatment), and compared with matched groups of non-institutionalized schizophrenics, patients with first schizophrenic episodes, institutionalized and non-institutionalized patients with primary affective disorder, and neurotic out-patients. Age was significantly correlated (P< 0·0002) with lateral ventricular size, but the institutionalized schizophrenic patients had significantly larger (P< 0·025) lateral ventricles than the neurotics when age was taken into account. Ventricular enlargement was unrelated to past physical treatment (neuroleptics, insulin coma and electroconvulsive therapy).Within the group of institutionalized schizophrenic patients few correlates of ventricular enlargement were identified; thus in this population increased ventricular size was not clearly associated with the features of the defect state (negative symptoms and intellectual impairment). however, there was a curvilinear (inverted-U) relationship between intellectual function and ventricular size was significantly related to absence of hallucinations, impairment of social behaviour, inactivity and the presence of abnormal involuntary movements.The findings confirm that structural brain changes do occur in chronic schizophrenia, but illustrate some of the difficulties in elucidating the clinical significance of ventricular enlargement. Lateral not bimodal; the relationship to particular features of the disease is complex and likely to emerge only in studies with a large sample size.

scholarly journals Pengaruh Terapi Tambahan Asam Folat Dan Kobalamin Terhadap Gejala Skizofrenia Kronik

2017 ◽  
Vol 6 (2) ◽  
Author(s):  
Betty Hidayati ◽  
Aris Sudiyanto ◽  
Moh. Fanani
Keyword(s):  
Folic Acid ◽  
Negative Symptoms ◽  
Controlled Trial ◽  
Intervention Group ◽  
Chronic Schizophrenia ◽  
Current Treatment ◽  
Cobalamin Deficiency ◽  
Treatment Regimens ◽  
Therapeutic Benefits ◽  
Schizophrenic Patients

Abstract: Folic Acid, Cobalamin, Symptoms, Schizophrenia. Schizophrenic patients have low levels of folic acid and cobalamin. Deficiency of folic acid and cobalamin can cause neurological and psychiatric disorders. Supplementation of folic acid and cobalamin may provide therapeutic benefits through different mechanisms of current treatment regimens. To assess the effectiveness of additional therapies of folic acid and cobalamin in improving the negative symptoms and length of stay of chronic schizophrenic patients. This study was an experimental study with randomized controlled trial group, pre-post test design. The intervention group had significant PANSS score improvementin positive symptoms (p = 0,01), negative symptoms (p = 0,004), general psychopathologies (p = 0,01) and PANSS total score (p = 0,014) subscales. ONE-WAY ANAVA statistic analysis result shows significant reduction in all four subscales (p = 0,000). Adding folic acid and vitamin B12 as adjuvant therapy with standard antipsychotic medication effective in reducing chronic schizophrenia symptoms.

scholarly journals Antipsychotic Augmentation with Venlafaxine for Treatment of Negative Symptoms in Chronic Schizophrenia - A Case Series

2017 ◽  
Vol 3 (2) ◽  
pp. 164
Author(s):  
Elizabeta B. Mukaetova-Ladinska ◽  
Joaquim Alves Da Silva ◽  
Jon Darley
Keyword(s):  
Antipsychotic Medication ◽  
Negative Symptoms ◽  
Case Series ◽  
Chronic Schizophrenia ◽  
Deficit Syndrome ◽  
Community Adaptation ◽  
Conventional Antipsychotics ◽  
Core Feature ◽  
Schizophrenic Patients ◽  
Overall Functioning

Negative symptoms represent a core feature in schizophrenia and the deficit syndrome in chronic schizophrenic patients is closely related to their poor outcome and global failure in community adaptation. Atypical antipsychotics have been widely used in the treatment of negative symptoms in schizophrenia, and tend to produce a better response when used in association with antidepressants. We describe a case series of patients with a clinical diagnosis of residual type of schizophrenia, who have undergone an augmentative treatment of antipsychotic medication with venlafaxine. Both primary and secondary negative symptoms, as well as the overall functioning in these patients were substantially improved following this treatment. This is the first clinical study describing the combination of venlafaxine with both conventional antipsychotics and novel antipsychotics, such as risperidone, to treat successfully both secondary and primary negative symptoms in schizophrenia. We also discuss possible modes of action of the joint use of this particular antidepressant with antipsychotic medication. 

Changes in the Positive and Negative Symptoms of Schizophrenic In-patients in China

1991 ◽  
Vol 159 (2) ◽  
pp. 226-231 ◽  
Author(s):  
Michael R. Phillips ◽  
Zuan Zhao ◽  
Xianzhang Xiong ◽  
Xiufang Cheng ◽  
Guirong Sun ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Psychiatric Hospitals ◽  
Chronic Schizophrenia ◽  
First Episode ◽  
Positive Symptoms ◽  
Positive Type ◽  
Duration Of Illness ◽  
Assessment And Treatment ◽  
Schizophrenic Patients ◽  
Positive And Negative Symptoms

Positive and negative symptoms at admission and discharge of 401 unselected schizophrenic patients from four psychiatric hospitals around China were studied. On admission, 58% of patients had prominent negative symptoms and the overall severity of negative symptoms was similar to that of positive symptoms; at discharge, negative symptoms were more prevalent and more severe. The severity of negative symptoms was not significantly correlated with duration of illness or with dosage of medication; 48% of first-episode, drug-naive patients had prominent negative symptoms on admission. Negative symptoms responded to standard neuroleptic treatment, but the improvement was less marked than that in positive symptoms (47% v. 80%). The proportion of patients classified as positive type, negative type, and mixed type schizophrenia altered dramatically with treatment. These findings highlight the importance of negative symptoms in the assessment and treatment of both acute and chronic schizophrenia.

Clinical evaluation of negative symptoms in schizophrenia

2007 ◽  
Vol 22 (6) ◽  
pp. 380-386 ◽  
Author(s):  
Hans-Jürgen Möller
Keyword(s):  
Differential Diagnosis ◽  
Negative Symptoms ◽  
Rating Scales ◽  
Unmet Need ◽  
Cognitive Disorders ◽  
Accurate Diagnosis ◽  
Positive Symptoms ◽  
Clinical Algorithms ◽  
Rule Out

AbstractThe florid positive symptoms of schizophrenia (hallucinations, delusions, grossly disordered thinking) are often obvious. By comparison, negative symptoms (flattened affect, impoverished speech, apathy, avolition, anhedonia) are subtler and more difficult to recognize and diagnose. However, there is increasing recognition of the importance of negative symptoms in patients with schizophrenia. Secondary negative symptoms attributable to such factors as unrelieved positive symptoms, the adverse effects of antipsychotic pharmacotherapy, or social isolation may subside with resolution of such factors. In contrast, primary negative symptoms are an intrinsic aspect of schizophrenia; they are persistent and have been associated with poorer clinical outcomes. Although the lack of a reliably effective treatment for negative symptoms is a serious unmet need in this patient population, accurate diagnosis is still important. Assessment of suspected negative symptoms, using validated rating scales, can help to rule out comorbid affective or cognitive disorders that may mimic negative symptoms and to distinguish primary negative symptoms from potentially reversible secondary negative symptoms. This article reviews the definitions and classification of negative symptoms, compares the tools available for their assessment, and offers practical clinical algorithms for sorting through the differential diagnosis.

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