scholarly journals Primary and Secondary Negative Symptoms in Schizophrenia

2022 ◽  
Vol 12 ◽  
Author(s):  
Sergey N. Mosolov ◽  
Polina A. Yaltonskaya
Keyword(s):  
Emotional Disorders ◽  
Negative Symptoms ◽  
Social Withdrawal ◽  
Detailed Comparison ◽  
Point Of View ◽  
Assessment Tools ◽  
Clinical Aspects ◽  
Clinical Impression ◽  
Positive And Negative Symptoms

The negative symptoms of schizophrenia include volitional (motivational) impairment manifesting as avolition, anhedonia, social withdrawal, and emotional disorders such as alogia and affective flattening. Negative symptoms worsen patients' quality of life and functioning. From the diagnostic point of view, it is important to differentiate between primary negative symptoms, which are regarded as an integral dimension of schizophrenia, and secondary negative symptoms occurring as a result of positive symptoms, comorbid depression, side effects of antipsychotics, substance abuse, or social isolation. If secondary negative symptoms overlap with primary negative symptoms, it can create a false clinical impression of worsening deficit symptoms and disease progression, which leads to the choice of incorrect therapeutic strategy with excessive dopamine blocker loading. Different longitudinal trajectories of primary and secondary negative symptoms in different schizophrenia stages are proposed as an important additional discriminating factor. This review and position paper focuses primarily on clinical aspects of negative symptoms in schizophrenia, their definition, phenomenology, factor structure, and classification. It covers the historical and modern concepts of the paradigm of positive and negative symptoms in schizophrenia, as well as a detailed comparison of the assessment tools and psychometric tests used for the evaluation of negative symptoms.

Brain-based psychotherapy for psychosis

2017 ◽  
Vol 41 (S1) ◽  
pp. s823-s823
Author(s):  
L. Mehl-Madrona ◽  
B. Mainguy
Keyword(s):  
Quality Of Life ◽  
Negative Symptoms ◽  
Life Experiences ◽  
Brain Area ◽  
Future Orientation ◽  
Narrative Approach ◽  
Brain Areas ◽  
Competing Interest ◽  
Positive And Negative Symptoms

IntroductionPsychotherapy methods are evolving for patients with psychosis.MethodsWe present a psychotherapy of psychosis that is brain-based, along with results of working with patients using these methods. Patients with psychosis are known to have decreased connectivity of the elements of the default mode network, also known as the story-making brain. These patients are known to tell narratives that lack coherence, of both excessive elements and inadequate elements. These stories are rigid and either cacophonous or rigidly monologic. The key brain area of the precuneus shows diminished connectivity to other brain areas. We present a narrative approach in which patients are assisted through rehearsal and modeling to tell more coherent stories about their life experiences. We work toward achieving a future orientation in which a sequence of actions leads toward an achievement of a future goal. The protagonist encounters obstacles and learns how to overcome them. Through iterative rehearsals, the story achieves more vivid mental imagery and emotional connectivity. Delusions and voices are accepted and incorporated into those stories in ways that provide the patient with improved capacity to cope with their delusions and voices.ResultsWe present the results of 59 patients who worked with these techniques and compare them to a matched cohort of patients treated conventionally. The treated patients show statistically significant improvement in positive and negative symptoms and in quality of life.DiscussionBrain-based narrative psychotherapy approaches can improve the quality of life and reduce symptoms.ConclusionThese techniques are worthy of further exploration.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Physician observations and perceptions of positive and negative symptoms of schizophrenia: A multinational, cross-sectional survey

2007 ◽  
Vol 22 (6) ◽  
pp. 371-379 ◽  
Author(s):  
Yves Lecrubier ◽  
Richard Perry ◽  
Gary Milligan ◽  
Oscar Leeuwenkamp ◽  
Robert Morlock
Keyword(s):  
Negative Symptoms ◽  
Social Withdrawal ◽  
The United States ◽  
Positive Symptoms ◽  
Prescribing Practices ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The United Kingdom ◽  
Antipsychotic Prescribing ◽  
Positive And Negative Symptoms

AbstractPurposeTo describe physicians' observations and perceptions of patients with schizophrenia and to obtain information about antipsychotic prescribing practices.MethodsPsychiatrists in the United States and five European countries (France, Germany, Italy, Spain, and the United Kingdom) who prescribed antipsychotics for ≥15 patients with schizophrenia within the preceding 3 months provided data on their patients' demographic and clinical characteristics and their antipsychotic prescribing practices and drug attributes influencing treatment choice.ResultsData were collected from 872 physicians on 6523 patients (85% European, 15% US). Most patients were aged 25–44 years, 63% were men, and 66% were outpatients. About 50% of patients were moderately to grossly dysfunctional; about 50% were unemployed; 34% and 75% were taking conventional or atypical antipsychotics, respectively. Frequently identified positive symptoms included delusions (73%), disordered thought (59%), and hallucinations (59%); common negative symptoms included social withdrawal (54%), impoverished thought (39%), and blunted affect (38%). Reasons for antipsychotic selection included efficacy for positive (90%) or negative symptoms (62%) and tolerability (47%). Inadequate control was reported more frequently for negative (71–77%) than positive (47–60%) symptoms. Adverse events included sedation, weight gain, and extrapyramidal symptoms.ConclusionsIn this large, multinational, cross-sectional survey, physicians reported that positive symptoms were more common than negative symptoms. Treatment for positive symptoms was more successful than that for negative symptoms, with physicians considering treatment inadequate for >70% of patients with negative symptoms.

Bupropion Increases Rate of Smoking Abstinence in Smokers with Schizophrenia: A Systematic Review and Meta-analysis of Randomised Trial Data

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
D.T.-Y. Tsoi ◽  
M. Porwal ◽  
A.C. Webster
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Negative Symptoms ◽  
Meta Analysis ◽  
Randomised Trial ◽  
Smoking Abstinence ◽  
End Of Treatment ◽  
Randomised Controlled ◽  
Positive And Negative Symptoms

Aims:In patients with schizophrenia, higher rates of tobacco dependency contribute significantly to increased morbidity and mortality of various physical illnesses. However, evidence for treatment of nicotine addiction in these patients is uncertain. We performed a systematic review of the effectiveness and safety of bupropion (Zyban) for smoking cessation in schizophrenia.Method:We searched databases and conference proceedings for reports of randomised controlled trials (RCTs) in all languages, comparing bupropion with placebo or with a different therapeutic control in adult smokers with schizophrenia. Eligibility and quality of RCTs were independently assessed by two reviewers. Results are synthesised using a random effects model and expressed as Risk Ratio (RR) and mean difference (MD), both with 95% confidence interval (CI).Results:16 reports from six RCTs were included (258 participants). Smoking cessation rates after bupropion were significantly higher than placebo at the end of bupropion treatment (RR 2.56, CI 1.46 to 4.50) and at six months (RR 2.82, CI 1.04 to 7.69). Expired carbon monoxide level was significantly lower with bupropion at the end of therapy (MD -5.39ppm, CI -7.43 to -3.34ppm) but the effect was not sustained at six months (p=0.33). Positive and negative symptoms were not significantly different between bupropion and placebo group, but depressive symptoms were significantly reduced with bupropion at the end of treatment. There were no seizures reported with bupropion use.Conclusion:Our review suggests that bupropion increases the rates of smoking abstinence in smokers with schizophrenia, without jeopardising their mental state.

scholarly journals Quality of life assessment of patients with schizophrenic spectrum disorders from Psychosocial Care Centers

2011 ◽  
Vol 60 (2) ◽  
pp. 91-98 ◽  
Author(s):  
Tatiana Fernandes Carpinteiro da Silva ◽  
Vanessa Mason ◽  
Lúcia Abelha ◽  
Giovanni Marcos Lovisi ◽  
Maria Tavares Cavalcanti
Keyword(s):  
Quality Of Life ◽  
Negative Symptoms ◽  
Psychiatric Hospitalization ◽  
Psychiatric Symptoms ◽  
Psychosocial Care ◽  
Life Assessment ◽  
Cross Sectional ◽  
Quality Of Life Scale ◽  
Positive And Negative Symptoms

OBJECTIVE: Assessing the quality of life and the clinical and social-demographic factors associated in schizophrenic spectrum patients (ICD-10 F20-F29) attending CAPS at the programmatic area 3.0. METHODS: A cross-sectional study was carried out in a sample of schizophrenic spectrum patients who have been enrolled in 2008 in CAPS in programmatic area (AP) 3 at Rio de Janeiro city, using MINIPLUS to assess schizophrenia spectrum disorder and use of psychoactive substances, Positive and Negative Symptoms Scale (PANSS) to assess psychiatric symptoms and Quality of Life Scale (QLS-BR) to assess the quality of life. RESULTS: Seventy nine patients were included, of whom 74 (93.7%) presented some impairment in quality of life. The most frequently affected area was occupational performance. Variables that showed a significant association with severe impairment of quality of life were: marital status, race, occupation, who patients lived with, homelessness, having children, previous psychiatric hospitalization, negative symptoms and symptoms designated as not applicable (being characterized by a lack of typical positive and negative symptoms). CONCLUSION: The knowledge of these factors should be crucial to implement health policies and psychosocial rehabilitation programs focused on improving the quality of life of these patients.

scholarly journals Quality of life in patients with psoriatic arthritis

2021 ◽  
Vol 97 (3) ◽  
pp. 56-65
Author(s):  
Kseniya Mikhailovna Koreshkova ◽  
Zarema Rimovna Khismatullina
Keyword(s):  
Quality Of Life ◽  
Psoriatic Arthritis ◽  
Emotional Disorders ◽  
Pain Syndrome ◽  
Point Of View ◽  
Women Patients ◽  
Social And Emotional ◽  
Rate Of Progression ◽  
Standing Up

Currently, the prevalence of PsA in the population is 0.05-1.6%. In terms of the rate of progression, deterioration of the quality of life and disability, PsA patients are comparable to rheumatoid arthritis and ankylosing spondylitis. Purpose: to study the effect of psoriatic arthritis on the quality of life of patients. Materials and methods. A study was conducted with the participation of 75 patients. For the study, we used standardized questionnaires developed to assess the quality of life of patients with PsA. Research method - questioning patients using standardized questionnaires, analysis of the information received. Results. Psoriatic arthritis has a significant impact on the quality of life of patients, affecting the physical, social and emotional spheres. The most important areas of influence of psoriatic arthritis from the point of view of patients are: pain (78%), skin problems (72%), decreased functionality (60%), discomfort (51%) and fatigue (44%). In patients with PsA, pronounced functional disorders are noted. The HAQ index in men averaged 1.98 0.86 (from 1.12 to 2.84 points), in women - 1.77 0.34 (from 1.44 to 2.11 points) (p 0.0001). The pain syndrome according to the VAS averaged 74.34 9.22 mm in men, and 65.77 8.19 mm in women. Patients noted the greatest disturbances in such activities as walking (44%), standing up (37%), hygiene procedures (21%), using transport (36%), housework (47%). Almost 40% of patients use various devices or the help of others (p 0.0001). Psoriatic arthritis also affects the emotional sphere of life. Subclinical emotional disorders were more often detected in women than in men (symptoms of anxiety - 61.9% and 42.2%, depression - 71.4% and 39.4%, respectively); however, approximately the same number of men had clinically expressed signs of depression ( 12.1%) and women (11.9%). Psoriatic arthritis significantly reduces the quality of life, affecting the most important aspects of it - physical, emotional and social.

scholarly journals A new nosology of psychosis and the pharmacological basis of affective and negative symptom dimensions in schizophrenia

2010 ◽  
Vol 2 (1) ◽  
pp. 28-38 ◽  
Author(s):  
Costa Vakalopoulos
Keyword(s):  
Bipolar Disorder ◽  
Muscarinic Receptor ◽  
Intracellular Signaling ◽  
Negative Symptoms ◽  
Point Of View ◽  
Clinical Impression ◽  
Symptom Dimensions ◽  
Deficit Syndrome ◽  
Signaling Systems ◽  
Affective Symptoms

Although first rank symptoms focus on positive symptoms of psychosis they are shared by a number of psychiatric conditions. The difficulty in differentiating bipolar disorder from schizophrenia with affective features has led to a third category of patients often loosely labeled as schizoaffective. Research in schizophrenia has attempted to render the presence or absence of negative symptoms and their relation to etiology and prognosis more explicit. A dichotomous population is a recurring theme in experimental paradigms. Thus, schizophrenia is defined as process or reactive, deficit or non-deficit and by the presence or absence of affective symptoms. Laboratory tests confirm the clinical impression showing conflicting responses to dexamethasone suppression and clearly defined differences in autonomic responsiveness, but their patho-physiological significance eludes mainstream theory. Added to this is the difficulty in agreeing to what exactly constitutes useful clinical features differentiating, for example, negative symptoms of a true deficit syndrome from features of depression. Two recent papers proposed that the general and specific cognitive features of schizophrenia and major depression result from a monoamine-cholinergic imbalance, the former due to a relative muscarinic receptor hypofunction and the latter, in contrast, to a muscarinic hypersensitivity exacerbated by monoamine depletion. Further development of these ideas will provide pharmacological principles for what is currently an incomplete and largely, descriptive nosology of psychosis. It will propose a dimensional view of affective and negative symptoms based on relative muscarinic integrity and is supported by several exciting intracellular signaling and gene expression studies. Bipolar disorder manifests both muscarinic and dopaminergic hypersensitivity. The greater the imbalance between these two receptor signaling systems, the more the clinical picture will resemble schizophrenia with bizarre, incongruent delusions and increasingly disorganized thought. The capacity for affective expression, by definition a non-deficit syndrome, will remain contingent on the degree of preservation of muscarinic signaling, which itself may be unstable and vary between trait and state examinations. At the extreme end of muscarinic impairment, a deficit schizophrenia subpopulation is proposed with a primary and fixed muscarinic receptor hypofunction. The genomic profile of bipolar disorder and schizophrenia overlap and both have a common dopaminergic intracellular signaling which is hypersensitive to various stressors. It is proposed that the concomitant muscarinic receptor upregulation differentiates the syndromes, being marked in bipolar disorder and rather less so in schizophrenia. From a behavioral point of view non-deficit syndromes and bipolar disorder appear most proximate and could be reclassified as a spectrum of affective psychosis or schizoaffective disorders. Because of a profound malfunction of the muscarinic receptor, the deficit subgroup cannot express a comparable stress response. None -theless, a convergent principle of psychotic features across psychiatric disorders is a relative monoaminergic-muscarinic imbalance in signal transduction.

Schizophrenia spectrum and other psychotic disorders

2015 ◽  
pp. 159-176
Author(s):  
Martin Brüne
Keyword(s):  
Social Life ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Social Withdrawal ◽  
Social Rank ◽  
Signs And Symptoms ◽  
Point Of View ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Motor Abnormalities

Schizophrenia spectrum disorders are characterized by the presence of delusions, hallucination, disorganized thinking, motor abnormalities, and/or negative symptoms. Behaviourally, schizophrenia patients have profound difficulties in regulating approach and avoidance, causing social withdrawal or aggressive behaviour. Evolutionary hypotheses of schizophrenia abound, but none covers all phenotypic aspects of the syndrome(s). Genetic risk for schizophrenia is partly conferred by genes that have undergone positive selection, whereby the reproductive advantage compensating for the reduced fecundity is as yet unknown. Environmental risk factors for schizophrenia comprise poverty, migration, and urbanicity, which has given rise to the hypothesis that individuals with schizophrenia are particularly sensitive to the exposure of strangers. In a more general vein, many signs and symptoms associated with schizophrenia can be interpreted from an evolutionary point of view. They pertain to diverse aspects of social life, including cooperation and trust (paranoia), mating (delusional jealousy, erotomania), and social rank (catatonic stupor, mutism).

Modern clinical pharmacology approaches to negative symptom treatment in schizophrenia

2021 ◽  
Vol 7-8 (217-218) ◽  
pp. 53-61
Author(s):  
Natalya Raspopova ◽  
◽  
Sаida Yeshimbetova ◽  
Кuanysh Altynbekov ◽  
◽  
...  
Keyword(s):  
Negative Symptom ◽  
Negative Symptoms ◽  
Basic Mechanism ◽  
Receptor Subtypes ◽  
D3 Receptors ◽  
Drug Of Choice ◽  
Receptor Profile ◽  
Chronic Course ◽  
Positive And Negative Symptoms

Negative symptoms contribute to poor functional outcomes and quality of life for individuals with schizophrenia. Efficacy of negative symptom treatment in patients with schizophrenia are discussed by the example of a new atypical antipsychotic cariprazine (Reagila®). Discussion. Improved Receptor Profile: high affinity for D3 receptors and partial agonism for both dopamine receptor subtypes, may act as a basic mechanism for improving negative symptoms and cognitive impairment. Сonclusions. Сariprazine is the drug of choice in the treatment of adult patients both at the onset of the disease with a predominance of negative disorders, and in the chronic course of schizophrenia with positive and negative symptoms, especially in patients with a high risk of metabolic and cardiovascular disorders. Keywords: schizophrenia, negative disorders, antipsychotics, cariprazine.

Sleep quality in patients with positive and negative symptoms of schizophrenia

2018 ◽  
Vol 6 (2) ◽  
pp. 257 ◽  
Author(s):  
Faezeh Tatari ◽  
Habbibolah Khazaie ◽  
Pardis Parsapour ◽  
Leeba Rezaie
Keyword(s):  
Sleep Quality ◽  
Sleep Disorders ◽  
Negative Symptoms ◽  
Positive Symptoms ◽  
Quality Of Sleep ◽  
Significant Difference ◽  
Schizophrenic Patients ◽  
Delayed Sleep ◽  
Positive And Negative Symptoms

Background: Schizophrenia is a debilitating psychiatric disorder that primarily manifests itself in two ways, showing either positive or negative symptoms. Sleep disorders are one of the main attributes of this disorder that affects the quality of patients with schizophrenia. The evaluation of the quality of sleep in patients showing both positive and negative symptoms can be useful in the planning program of the diagnosis and treatment of these patients. Therefore, this study aimed to compare the quality of sleep of schizophrenic patients showing positive symptoms with those who show negative symptoms.Methods: This study was descriptive-analytic in nature. A total of 100 patients suffering from schizophrenia admitted to the Farabi Hospital in Kermanshah, Iran, during 2015-16, were considered for this study. We used convenience sampling to assign the participants into 2 groups of patients showing positive and negative symptoms of schizophrenia, respectively. The data were collected by conducting face-to-face interviews. Two questionnaires were used, namely, the Anderson Positive and Negative Symptoms Questionnaire and the Pittsburgh Sleep Quality Questionnaire. The data were analyzed with the SPSS-22 software.Results: There was a significant difference between the overall score of sleep quality in patients with positive and negative symptoms for schizophrenia (P = 0.046) with the patients with positive symptoms reporting poorer sleep quality. In addition, patients with the positive symptoms showed a higher impairment of daily functions than those with negative symptoms (p = 0.024). However, there was no significant difference in the subjective quality of sleep, delayed sleep, sleep duration, sleep disorders and the use of sleep medications between the 2 groups (P >0.05).Conclusion: According to the results of this study, the quality of sleep in patients with positive symptoms is poorer than those with negative symptoms, which is associated with a higher impairment in their daily functions. Therefore, attention to sleep quality is recommended during the person-centered treatment of these patients.

Sign in / Sign up

Export Citation Format

Share Document