Impact Of Negative Symptoms Research Articles

Does being defiant and irritable take a toll on physical health? Examining the covariation between symptoms of physical health and oppositional defiance across adolescence to young adulthood

Objectives. While oppositional defiance is often considered a childhood behavioural problem, the negative impact of symptoms on relationships and emotional wellbeing may endure well into young adulthood and can affect overall physical health. However, little is known about the co - occurrence of oppositional defiance symptoms (ODS) and changes in physical health functioning, particularly during the transition to young adulthood. This study examines the coupled change between ODS and physical health symptoms during this critical developmental period to inform the long - term somatic manifestations of ODS. Methods. Participants (N = 662; 52% female) from the Victoria Healthy Youth Survey (V-HYS) were assessed for ten years across six biennial occasions from ages 12–18 to ages 22–30. A multilevel time -varying covariation model, disaggregating within- and between - person variability, examined whether change in ODS was systematically associated with change in physical health symptoms. Results. On average, individuals with higher ODS reported more physical health symptoms. Moreover, ODS also shared a significant within - person time - varying association with physical health, suggesting that the two symptom domains fluctuated together within - individuals across time, irrespective of between - person differences. Conclusion. This study provides a novel within- and between - person demonstration of the link between ODS and physical health symptoms from youth to young adulthood.

Impact of negative symptoms on health-related quality of life in schizophrenia.

Evidence regarding the association of Negative Symptoms (NS) dimensions with Health-related Quality of Life (HRQoL) is limited and no prior study has looked into contributions of NS domains on HRQoL. This study bridges the gap by examining the associations of NS, its two dimensions (Motivation and Pleasure, and Emotional Expressivity) and five domains (Anhedonia, Avolition, Asociality, Blunted affect and Alogia) with HRQoL in schizophrenia. 274 individuals with schizophrenia were assessed on the Positive and Negative Syndrome Scale (PANSS) and Brief Negative Symptom Scale (BNSS). PANSS scores were mapped to EuroQol five-dimensional (EQ-5D-5L) utility scores using an algorithm previously validated in Singapore, and the resulting EQ-5D-5L scores were used as a measure of HRQoL. Multiple linear regression analyses of the two NS dimensions and five NS domains against EQ-5D-5L showed that a lower severity of NS, specifically that of the Motivation and Pleasure (MAP) dimension and asociality domain was associated with higher HRQoL. Our findings highlight the importance of targeting NS, particularly MAP and asociality, in improving HRQoL in schizophrenia.

Impact of Negative Symptoms on Functioning and Quality of Life in First Psychotic Episodes of Schizophrenia.

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.

The Impact of Negative Symptoms and Neurocognition on Functioning in MDD and Schizophrenia.

Introduction: Negative symptoms, neurocognitive deficits and functional impairment are prevalent in individuals with major depressive disorder (MDD) and schizophrenia (SCZ). However, unlike neurocognitive deficits, little is known about the role of negative symptoms toward functioning in individuals with MDD. On the other hand, both factors are well-studied in individuals with SCZ. Thus, this study aimed to examine the contributions of negative symptoms and neurocognitive impairments in functioning in individuals with MDD, compared to individuals with SCZ.Methods: Participants included 50 individuals with MDD, 49 individuals with SCZ and 49 healthy controls. The following measures were administered—Negative Symptom Assessment (NSA-16), Brief Assessment of Cognition in Schizophrenia (BACS), Patient Health Questionnaire (PHQ-9), and MIRECC-Global Assessment of Functioning (MIRECC-GAF) to evaluate negative symptoms, neurocognition, depressive symptoms, and functioning respectively.Results: Both MDD and SCZ groups had significantly more severe negative symptoms, depressive symptoms, and poorer functioning than healthy controls. Individuals with SCZ performed significantly poorer on the BACS than the other two groups. Both negative symptoms and neurocognition were significantly correlated with social and occupational functioning in SCZ. Motivation subdomain of the negative symptoms was significantly correlated with occupational functioning, while depressive symptoms correlated with functioning in MDD.Conclusion: Both negative symptoms and neurocognitive deficits appear to play differential roles on individual domains of functioning between MDD and SCZ. Future longitudinal studies with larger sample sizes should be done for a better understanding about the associations between the factors and functioning.

The impact of creativity on functional outcome in schizophrenia: a mediational model

Functional impairment remains one of the most challenging issues for treatment in schizophrenia. However, previous studies have mainly focused on the negative impact of symptoms excluding variables that could positively impact functional outcome, such as creativity, which is considered an adaptive capacity for real-life problem-solving. This study analyzed the predictive role of creativity on functional outcome in 96 patients with schizophrenia through a mediational model, including sociodemographic, clinical, neurocognitive, and social cognitive variables. Path analysis revealed that creativity significantly mediated the relationship between neurocognition and functional outcome, and that creativity mediated between negative symptoms and functional outcome. Additionally, neurocognition was directly associated with functional outcome and social functioning was associated with creativity. The involvement of creativity in functional outcome could have relevant implications for the development of new interventions. These findings open up a new field of research on additional personal resources as possible factors of functional outcome in schizophrenia and other diseases.

Patient Strategies for Managing the Vicious Cycle of Fatigue, Pain and Urgency in Inflammatory Bowel Disease: Impact, Planning and Support.

Inflammatory bowel disease (IBD) causes inter-related symptoms of fatigue, pain and urgency which can persist in remission. To understand how people with IBD experience and self-manage these symptoms and to inform the future development of an online self-management programme. Using exploratory qualitative methods, we recruited participants from clinic and community settings. Focus groups, conducted across the UK, were audio-recorded and professionally transcribed. Transcripts were analysed over four rounds using framework analysis. Eight patients were consulted to agree the final structure of data and themes. Seven focus groups were held; five gave useable data. Twenty-six participants (15 female; ages 21-60years; disease duration 2-40years) with Crohn's disease (n = 10), ulcerative colitis (n = 14) and IBD-unclassified (n = 2) attended one of these five focus groups. Three core themes emerged: The Negative Impact of Symptoms, Positively Taking Control and Seeking and Receiving Support. The persistent, often stark impact of multiple co-existing symptoms on physical and emotional wellbeing can force unwanted adjustments and limitations in working, social and intimate arenas of life. Unpredictable symptoms are challenging and impact each other in negative vicious cycles. Managing diet, pacing, accepting background levels of fatigue, pain and urgency, seeking support, exercising and attending to mental wellbeing, are all perceived as helpful in self-managing symptoms. Fatigue, pain and urgency are troublesome for patients, especially in combination, suggesting that these should be addressed simultaneously by clinicians. Participants reported several strategies for self-management, providing patient-focused evidence to inform future development of a self-management intervention programme.

Quality of life in women with endometriosis: a cross-sectional survey

PurposeThe aim of the study was to assess QoL and identify and analyse its determinants in women with endometriosis.MethodsThe study was performed in 2019 in health centres in Lublin (Poland) on 309 women with diagnosed endometriosis. In order to verify which factors affect QoL of the study participants, regression for qualitative variables (CATREG) was used. The applied research instruments included the WHOQOL-BREF quality of life questionnaire, the Acceptance of Illness Scale (AIS), the Laitinen Pain Scale, and a general questionnaire.ResultsThe overall QoL score of the respondents was 3.30, whereas their overall perceived health score was 2.37. The highest QoL scores were found for the psychological domain 13.33, whereas the lowest QoL were found for the physical domain 11.52. Women with endometriosis have a moderate level of illness acceptance (24.64) and experience daily pain of moderate intensity (5.83).ConclusionWomen with endometriosis rate their overall QoL higher than their overall perceived health. Perceived QoL in women with endometriosis is most commonly associated with their acceptance of illness, BMI, negative impact of symptoms on the relationship with the partner, and dyspareunia. To improve these women’s lives, care should also respond to the social, emotional, and sexual issues resulting from the illness. Such interventions will contribute to improved comfort and QoL among these women.

P.676 Are there regional differences in the impact of negative symptoms’ on perceptions of illness severity?

P.676 Are there regional differences in the impact of negative symptoms’ on perceptions of illness severity?

Impact of Mid-Life Symptoms of Alcoholism on the Health and Wellbeing of Aging Parents of Adults with Disabilities

ABSTRACTThe study examined the effect of adult children’s disability on parents’ physical health in later life and the extent to which parents’ symptoms of alcoholism in mid-life moderates the link between children’s disability and later life parental health. Analyses are based on data from the Wisconsin Longitudinal Study. The analytic sample included parents of children with developmental disabilities (n = 145) or mental health problems (n = 200) and 2,432 parents of unaffected children. The results showed that the negative health consequences in later life of having a child with a developmental disability were greater for those who showed more symptoms of alcoholism in mid-life. However, symptoms of alcoholism in mid-life did not significantly moderate the impact of an adult child’s mental health problems on parents’ later life physical health. The findings suggest a potential area where gerontological social workers could intervene, given the negative impact of symptoms of alcoholism on the health of aging parents of children with a disability who may be significantly more susceptible to the negative health impacts of alcohol compared to their younger counterparts.

Impact of Negative Symptoms on Quality of Life in Patients with Schizophrenia

The present study analyses the impact and influence of negative symptoms on quality of life (QoL). The W-SOHO study is a three year follow-up study on the outpatient care of schizophrenia that included 17,384 patients from 37 countries. Patients were recruited in W-SOHO by their treating psychiatrists when starting or changing antipsychotic medication. Evaluation was conducted during the normal course of care and was scheduled every six months after the baseline visit. The Clinical Global Impressions Severity Scale – Schizophrenia version (CGI-SCH) was used to assess symptom severity across overall, positive, negative, depressive and cognitive subdomains. Quality of life (QoL) was assessed using the EuroQOL 5-D questionnaire. Pearson correlation coefficients (PCC) were used to analyze the relationship between continuous variables. A mixed model with repeated measures (MMRM) was used to analyze the factors associated with quality of life during follow-up. Quality of life at baseline was more highly correlated with negative symptoms than with positive symptoms (PCC -0.25 for positive symptoms and -0.29 for negative symptoms; p<0.001). Improvement in negative symptoms was highly correlated to improvement in QoL (PCC 0.33; p<0.0001). The regression model analysing the influence of both positive and negative symptoms on QoL at baseline was confirmative and showed a greater beta coefficient (higher influence) for negative symptoms compared with positive symptoms [(3.9 (se 0.14) versus 2.9 (se 0.13)]. Another model found that patients with greater negative symptoms at baseline experienced lower improvement in QoL (beta coefficient -0.81; se 0.11; p<0.001). In patients with schizophrenia negative symptoms seem to have a larger influence onself-perceived QoL than positive symptoms. Improvement in negative symptoms is highly associated with improvements in QoL.

C.05.02 Assessment of functioning and quality of life in schizophrenia and the relevance for clinical practice

Many patients with schizophrenia suffer from poor social functioning, with high levels of unemployment being one particular consequence. Negative symptoms tend to persist during periods of clinical stability and may have a detrimental effect on function. This paper aims to investigate the relationship between negative symptoms and ability to function.The EGOFORS study measured negative symptoms in 295 schizophrenia patients in 11 European sites using the PANSS Negative Subscale and assessment scales for psychosocial function: Global Assessment of Functioning (GAF), Personal and Social Performance (PSP), Quality of Life Scale (QLS), Functional Remission of General Schizophrenia (FROGS), Psychosocial Remission in Schizophrenia (PSRS) and Subjective Wellbeing under Neuroleptics (SWN). The relationships between the PANSS Negative Subscale and the functional scales were investigated, adjusting for differences between study sites. Being in work, duration of illness, age of onset and number of years of education were also investigated for a relationship with function.There were strong, statistically significant correlations between PANSS Negative Subscale and all of the function scales (95% confidence intervals for the correlation coefficients: PSRS 0.77–0.91; FROGS 0.74–0.89; QLS 0.74–0.92; GAF 0.64–0.78; PSP 0.63–0.80) except the SWN. All of the functional scales except SWN were at least moderately related to one another. All of the items in each of the PANSS Negative Subscale and the function scales contributed to the relationships between them. Better functioning correlated strongly with participants being in work.This study shows a strong and significant relationship between negative symptoms and psychosocial functioning. Given the impact of negative symptoms on psychosocial function, much more emphasis should be placed on developing effective treatments for negative symptoms, given that most patients with schizophrenia now live in community settings and require to function adequately to support their quality of life.

The Impact of Negative Symptoms On Real Life Functioning of People with Schizophrenia

Introduction Several studies have reported an unfavorable impact of schizophrenia negative symptoms on patients’ functional outcome. Both direct and indirect relationships have been found between this psychopathological domain and patients’ functioning in real-life, and evidence that negative symptoms mediate the impact of other variables (i.e., neurocognition or functional capacity) on real-life functioning has also been provided. However, limitations of previous studies might prevent solid conclusions and generalizability. In particular, largely used scales for the assessment of negative symptoms have been criticized for the inclusion of items assessing neurocognition and for their focus on behavioral aspects, as opposed to internal experience, which may lead to artefactual associations with functional outcome measures; moreover, negative symptoms have generally been regarded as a unitary construct, while the most recent literature suggests that these symptoms are heterogeneous and include at least two factors, ‘avolition” and ‘poor emotional expression” (PEE). Methods Recent studies by our group and by the Italian Network for Research on Psychoses examined the hypothesis that avolition and PEE might be underpinned by different pathophysiological substrates and show different relationships to functional outcome. Results Avolition showed a higher predictive value of functional outcome than PEE. The latter had a modest contribution to functional capacity, which was not independent of cognitive dysfunction. Conclusions Efforts aimed to improve our understanding of the pathophysiology of avolition represent a priority of research in schizophrenia, and the implementation of treatments targeting motivation is likely to be an important tool to enable people with schizophrenia to achieve a meaningful life.

Impact of negative symptoms on healthcare resource utilization and associated costs in adult outpatients with schizophrenia: a population-based study.

BackgroundTo evaluate the prevalence and impact of negative symptoms on healthcare resources utilization and costs in patients with schizophrenia.MethodsA retrospective study was conducted using electronic medical records from the health provider BSA (Badalona, Spain). All adult outpatients with a diagnosis of schizophrenia were followed for 12 months. Two study groups were defined by the presence or absence of negative symptoms based on the PANSS Negative Symptoms Factor (N1-N4, N6, G7 and G16). Healthcare (direct cost) and non-healthcare costs (work productivity losses) were described. An ANCOVA model was used for correction, p < 0.05.ResultsOne thousand one hundred and twenty patients were included in the study (mean age: 46.8 ± 13.8 years; male: 58.4%). One or more negative symptoms were present in 52.5% of patients (95% CI: 49.6-55.4%). The most frequent were passive/apathetic social withdrawal and emotional withdrawal (60.5% and 49.8%, respectively). Patients with negative symptoms showed a greater mean number of comorbid conditions and pharmacological treatments. The adjusted unit healthcare cost related to the presence/absence of negative symptoms was €2,190.80 and €1,787.60 and the healthcare cost was €2,085.00 and €1,659.10, respectively; (p < 0.001). Patients with negative symptoms used more healthcare resources, mainly derived from primary care. The presence of negative symptoms was associated with being male, dyslipidemia, obesity and arterial hypertension (OR = 1.7, 1.4, 1.4 and 1.2, respectively).ConclusionsNegative symptoms are highly prevalent in adult outpatients with schizophrenia with a relevant economic impact on the healthcare system.

A Meta-Study of Qualitative Research Into the Experience of ‘Symptoms’ and ‘Having a Diagnosis’ for People Who Have Been Given a Diagnosis of Bipolar Disorder

The purpose of this study is to review the current state of the literature reporting qualitative studies that depict the experiences of ‘symptoms’ and ‘having a diagnosis’ for people who have been given a diagnosis of bipolar disorder. The method attempted to combine empirical and discursive approaches and was strongly influenced by guidance from Paterson, Thorne, Canam, and Jillings (2001) on conducting a meta-review. Meta-data analysis was used to compare the studies and, subsequently, nine common themes emerged: ‘struggles with identity’, ‘loss of control’, ‘disruption, uncertainty and instability’, ‘negative impact of symptoms across life and the experience of loss’, ‘negative view of self’, ‘positive or desirable aspects of mania’, ‘struggling with the meaning of diagnosis’, ‘stigma’, and ‘acceptance and hope’. The meta-method explored and evaluated the qualitative methods that have been used to study this phenomenon, and the meta-theory considered the theoretical underpinnings and contributions of this research. The review concludes that an awareness of these themes could support clinical work with service-users and inform the development of relevant interventions such as interpersonal social rhythm therapy, cognitive behavioural therapy and mindfulness-based cognitive therapy. Further qualitative research is recommended to extend this literature base and include a greater representation of men and people living in non-westernised countries. Note This is a newer version of an article published in EJOP, Vol. 9 Issue 2 (2013) . In the following publication some section headings were added which had been lost during document production.

The Prevalence of Negative Symptoms in Schizophrenia and Their Impact on Patient Functioning and Course of Illness

Article AbstractPatients with schizophrenia may not complain about negative symptoms, but at least half of them suffer from a lack of energy, pleasure, emotion, or social abilities. These deficits affect patients†long-term functioning, outcomes, and quality of life. This activity explores the structure, prevalence, diagnosis, and impact of negative symptoms, which have long been ignored as treatment targets. More research is needed on effective treatments for primary and persistent negative symptoms to help clinicians better address these issues and improve the often seriously impaired social and occupational functioning of their patients.See the entire activity.

Negative symptoms and psychosocial functioning in schizophrenia: Neglected but important targets for treatment

BackgroundMany patients with schizophrenia suffer from poor social functioning, with high levels of unemployment being one particular consequence. Negative symptoms tend to persist during periods of clinical stability and may have a detrimental effect on function. This paper aims to investigate the relationship between negative symptoms and ability to function. MethodsThe EGOFORS study measured negative symptoms in 295 schizophrenia patients in 11 European sites using the PANSS Negative Subscale and assessment scales for psychosocial function: Global Assessment of Functioning (GAF), Personal and Social Performance (PSP), Quality of Life Scale (QLS), Functional Remission of General Schizophrenia (FROGS), Psychosocial Remission in Schizophrenia (PSRS) and Subjective Wellbeing under Neuroleptics (SWN). The relationships between the PANSS Negative Subscale and the functional scales were investigated, adjusting for differences between study sites. Being in work, duration of illness, age of onset and number of years of education were also investigated for a relationship with function. ResultsThere were strong, statistically significant correlations between PANSS Negative Subscale and all of the function scales (95% confidence intervals for the correlation coefficients: PSRS 0.77–0.91; FROGS 0.74–0.89; QLS 0.74–0.92; GAF 0.64–0.78; PSP 0.63–0.80) except the SWN. All of the functional scales except SWN were at least moderately related to one another. All of the items in each of the PANSS Negative Subscale and the function scales contributed to the relationships between them. Better functioning correlated strongly with participants being in work. ConclusionThis study shows a strong and significant relationship between negative symptoms and psychosocial functioning. Given the impact of negative symptoms on psychosocial function, much more emphasis should be placed on developing effective treatments for negative symptoms, given that most patients with schizophrenia now live in community settings and require to function adequately to support their quality of life.

Prediction of symptom remission in schizophrenia during inpatient treatment

Objective: Standardized consensus criteria for remission in schizophrenia were recently proposed. The present study applied the symptom-severity component of these criteria to a sample of inpatients in order to determine the rates of remission during inpatient treatment and to explore predictors of remission. Method: A total of 288 inpatients from a multi-centre follow-up programme who fulfilled ICD-10 criteria for schizophrenia were included in the present analyses. PANSS ratings at admission and at discharge from hospitalization were used to examine remission status. Clinical and sociodemographic variables at admission were tested for their ability to predict remission at discharge. Results: In total, 55% of the sample achieved symptom remission during inpatient treatment; 84% percent showed remission with respect to ‘reality distortion’, 85% with respect to ‘disorganization’ and only 65% with respect to ‘negative symptoms’. Logistic regression analysis revealed that the global functioning (GAF) in the year before admission, the total score of the Strauss–Carpenter Prognostic Scale and the PANSS negative subscore at admission were predictive for symptom remission. The regression model showed a predictive value of about 70% and explained 36% of the observed variance. Conclusion: The results highlight the impact of negative symptoms for the course and treatment response of schizophrenic illness.