Abstract
Schizophrenia is associated with heterogeneous course of positive and negative symptoms. In addition, reduced motor activity as measured by wrist actigraphy has been reported. However, longitudinal studies of spontaneous motor activity are missing. We aimed to explore whether activity levels were stable within and between psychotic episodes. Furthermore, we investigated the association with the course of negative symptoms. In 45 medicated patients, we investigated motor behavior within a psychotic episode. In addition, we followed 18 medicated patients across 2 episodes. Wrist actigraphy and psychopathological ratings were applied. Within an episode symptoms changed but activity levels did not vary systematically. Activity at baseline predicted the course of negative symptoms. Between two episodes activity recordings were much more stable. Again, activity at the index episode predicted the outcome of negative symptoms. In sum, spontaneous motor activity shares trait and state characteristics, the latter are associated with negative symptom course. Actigraphy may therefore become an important ambulatory instrument to monitor negative symptoms and treatment outcome in schizophrenia.
Highlights
Schizophrenia is characterized by positive symptoms, negative symptoms, and disorganization
positive and negative syndrome scale (PANSS) positive and PANSS total scores were attenuated, a trend for improvement was detected in PANSS negative scores
Baseline activity level (AL) inversely correlated at trend level with% of change of activity (r = −0.286; p = 0.063), indicating that the less patients move at baseline the more likely AL changes within episodes
Summary
Schizophrenia is characterized by positive symptoms, negative symptoms, and disorganization. Cognitive and motor symptoms have been identified as relevant symptom clusters of schizophrenia. The current DSM5 concept of psychoses proposed eight dimensions of psychopathology to be assessed in subjects with schizophrenia, including motor symptoms [1]. Schizophrenia is further associated with particular heterogeneity in course and outcome [2, 3]. Symptoms ameliorate during the course of a psychotic episode; negative symptoms do not respond as well to treatment as positive symptoms and disorganization too [4, 5]. In longitudinal studies over years, negative symptoms generally tend to be stable [5, 6]. Findings of a recent meta-analysis suggest that negative symptoms may improve to a greater extent than what has previously been assumed [7]
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