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.
Highlights
IntroductionNegative symptoms of schizophrenia constitute a therapeutic challenge, as well as one of the main areas to consider in order to improve functioning (proper behaviors in real-world social situations) [1] and quality of life (the individual’s perception of their position in life in the context of the culture and value systems) [2] in people with their first psychotic episodes of schizophrenia [3]
Negative symptoms of schizophrenia constitute a therapeutic challenge, as well as one of the main areas to consider in order to improve functioning [1] and quality of life [2] in people with their first psychotic episodes of schizophrenia [3]
The proportion of variance in Functioning Assessment Short Test (FAST) scores explained by the model was substantial
Summary
Negative symptoms of schizophrenia constitute a therapeutic challenge, as well as one of the main areas to consider in order to improve functioning (proper behaviors in real-world social situations) [1] and quality of life (the individual’s perception of their position in life in the context of the culture and value systems) [2] in people with their first psychotic episodes of schizophrenia [3]. From the first description of the disorder recorded by Morel in 1852 [5], negative symptoms have long been recognized as a core and clinically meaningful feature of schizophrenia. The subsequent identification, under a dichotomous perspective of negative symptoms as opposed to the positive ones, was defined by Crow in the 1980s including blunted affect and poverty of speech, and later revised by Andreasen with the incorporation of avolition, anhedonia, asociability and attentional deficit, suggesting the existence of a different clinical phenotype and pathophysiological substrate when negative symptoms were predominant [8,9]. Carpenter advanced the concept of deficit schizophrenia and, differentiated between primary and secondary negative symptoms depending on whether they were inherent to the disease or the result of additional factors such as emotional reactions, mood disorders, pharmacological treatment or the response to environmental events. The presence of at least two of the following was further suggested: restricted affect, diminished emotional range, poverty of speech, curbing of interest, diminished sense of purpose and diminished social drive, as part of the diagnostic criteria for the deficit syndrome [10,11]
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