Negative Symptoms In Patients Research Articles

Effects of transcranial direct current stimulation (tDCS) on positive and negative symptoms in patients with schizophrenia

Effects of transcranial direct current stimulation (tDCS) on positive and negative symptoms in patients with schizophrenia

Striatal Response to Reward Anticipation as a Biomarker for Schizophrenia and Negative Symptoms: Effects, Test-Retest Reliability, and Stability Across Sites.

Ventral striatal hypoactivation during reward anticipation has consistently been observed in patients with schizophrenia. In addition, that hypoactivation has been shown to correlate negatively with negative symptoms, and in particular with apathy. However, little is known about the stability of these results over time and their reliability across different centers. In total, 67 patients with schizophrenia (15 females) and 55 healthy controls (13 females) were recruited in 2 centers in Switzerland and Germany. To assess the neural bases of reward anticipation, all participants performed a variant of the Monetary Incentive Delay task while undergoing event-related functional magnetic resonance imaging at baseline and after 3 months. Stability over time was measured using intra-class correlation (ICC(A,1)) and stability between centers was measured with mixed models. Results showed the expected ventral striatal hypoactivation in patients compared to controls during reward anticipation. We showed that these results were stable across centers. The primary analysis did not reveal an effect of time. Test-retest reliability was moderate for controls, and poor for patients. We did not find an association between ventral striatal hypoactivation and negative symptoms in patients. Our results align with the hypothesis that ventral striatal activation is related to modulation of motivational saliency during reward anticipation. They also confirm that patients with schizophrenia show impaired reward anticipation. However, the poor test-retest reliability and the absence of an association with symptoms suggests that further research is needed before ventral striatal activity can be used as a biomarker on the individual patient level.

Effort-cost decision-making associated with negative symptoms in schizophrenia and bipolar disorder

Motivational deficits and reduced goal-directed behavior for external rewards have long been considered an important features of negative symptoms in patients with schizophrenia (SCZ). Negative symptoms have also a high prevalence in bipolar disorder (BP). We used a transdiagnostic approach in order to examine association between negative symptoms and effort allocation for monetary rewards. 41 patients with SCZ and 34 patients with BP were enrolled in the study along with 41 healthy controls (HC). Effort-Expenditure for Rewards Task (EEfRT) was used to measure subjects' effort allocation for monetary rewards. Generalized estimating equation models were used to analyze EEfRT choice behavior. Negative symptoms were assessed using the Brief Negative Symptom Scale (BNSS). SCZ and BP groups expended lower effort to obtain a monetary rewards compared to HC. Severity of negative symptoms was negatively correlated with EEfRT performance in both diagnostic groups. Each diagnostic group showed lower effort allocation for monetary rewards compared to HC suggesting reduced motivation for monetary rewards. In addition, our results suggest that abnormal effort-based decision-making might be a transdiagnostic factor underlying negative symptoms.

DYNAMICS ASSESSMENT OF PSYCHOPATHOLOGICAL CHARACTERISTICS OF NEGATIVE SYMPTOMS IN SCHIZOPHRENIA

The aim of the study. To determine the dynamics of the psychopathological structure and severity of negative symptoms depending on the stage of the disease in patients with negative symptoms in schizophrenia in order to improve the diagnosis and treatment of patients with schizophrenia.
 Materials and methods: 252 patients with negative symptoms of schizophrenia took part in the study: 83 patients with the first episode of schizophrenia, 88 patients with schizophrenia in a state of exacerbation, and 81 patients with schizophrenia in a state of remission. A comprehensive approach, which consisted from clinical-psychopathological, psychometric (Scale for Evaluating Negative Disorders, G.V. Logvinovych, 1990) and statistical research methods, were used in the study.
 Results. Features of the dynamics of negative symptoms in patients with negative symptoms in schizophrenia at different stages of the disease were established: patients with the first episode of schizophrenia were characterized by mild quantitative and qualitative impairments in the emotional sphere, slight quantitative and qualitative changes in the associative sphere, and mild quantitative impairments in the volitional sphere in combination with moderate qualitative changes in the volitional sphere. Patients with schizophrenia in a state of exacerbation were characterized by moderate quantitative impairments of the emotional sphere and manifested distortion of the emotional sphere, manifested quantitative and qualitative impairments in the associative sphere and minor quantitative and qualitative impairments of the volitional sphere. Patients with schizophrenia in a state of remission were characterized by moderate and manifested quantitative and qualitative impairments in the emotional-volitional sphere and moderate quantitative and qualitative impairments in the associative sphere.
 Conclusions. The obtained data can be used to establish diagnostic criteria for patients with negative symptoms in schizophrenia, depending on the dynamics of the disease.

485 Investigating the Impact of Inflammation on White Matter Tracts using Diffusion Tensor Imaging that may Contribute to Motivational Deficits and Negative Symptoms in Patients with Schizophrenia

OBJECTIVES/GOALS: Previous research has linked inflammation to changes in brain reward circuitry and subsequent negative symptoms in patients with schizophrenia. This project aims to understand brain-immune interactions using diffusion tensor imaging (DTI) to investigate the impact of inflammatory markers on white matter (WM) tracts. METHODS/STUDY POPULATION: Patients with schizophrenia, ages 18 to 45, were recruited at Grady Hospital in Atlanta, GA. All subjects were stable outpatients and underwent extensive medical screening to rule out medical causes of acute inflammation. DTI data was collected from 39 participants on a 3-Tesla Siemens scanner. Blood was collected between 9-11AM for later assay of serum inflammatory markers. Negative symptoms were assessed using the Brief Negative Symptom Scale (BNSS). A diffusion tensor imaging model will be fitted with the data to generate well-known diffusion tensor measures (fractional anisotropy and mean diffusivity). Linear regression will be used to analyze the relationship between DTI measures and inflammation (C-Reactive Protein, CRP), controlling for possible confounders. RESULTS/ANTICIPATED RESULTS: The hypothesis of this proposal is that decreased microstructural integrity in WM tracts between the nucleus accumbens (NAc) and insula will be associated with increased inflammation, which in turn are associated with increased negative symptoms. Negative symptoms include deficits in motivation/pleasure as well as diminished expressivity, and are strongly associated with poor functional outcomes. Based on previous data from this sample demonstrating relationships between CRP and negative symptoms as well as CRP and fMRI functional connectivity between the NAc and insula, we anticipate results that demonstrate similar relationships with WM microstructural integrity, such as functional anisotropy and mean diffusivity. DISCUSSION/SIGNIFICANCE: Given the lack of treatment options for negative symptoms, this research will provide key data to further our understanding of the potential role of inflammation on neural circuits that underlie these symptoms, including WM integrity. This research also has the potential to inform future anti-inflammatory therapies for patients with schizophrenia.

Interaction between baseline BMI and baseline disease severity predicts greater improvement in negative symptoms in first-episode schizophrenia.

Several studies have reported that baseline symptom severity in patients with schizophrenia (SCZ) is associated with the efficacy of antipsychotic medication. Overweight/obesity is common in SCZ and has also been reported to be correlated with therapeutic response to antipsychotics. This study aimed to evaluate whether baseline body mass index (BMI) and disease severity were associated with improvements in negative symptoms in patients with first-episode and medication-naïve (FEMN) SCZ. A total of 241 FEMN patients were recruited in this study and treated with oral risperidone over 3months. Clinical symptoms were measured by the Positive and Negative Syndrome Scale (PANSS) and BMI was assessed at baseline and 3-month follow-up. We found that baseline BMI was correlated with the baseline severity of symptoms. Baseline BMI or baseline disease severity was associated with improvement in negative symptoms after 3months of treatment. Linear regression analysis indicated that the interaction of BMI and disease severity at baseline was associated with improvement in negative symptoms in the early stage of SCZ after controlling for sex, age, and dose of risperidone. Our study suggests that the interaction of baseline BMI and disease severity may play a role in predicting negative symptom improvement after 3months of risperidone treatment.

The Effect of an Emotion Recognition and Expression Program on the Alexithymia, Emotion Expression Skills and Positive and Negative Symptoms of Patients with Schizophrenia in a Community Mental Health Center

This study aimed to examine the effect of an emotion recognition and expression program (EREP) on the alexithymia, emotion expression skills and positive and negative symptoms of patients with schizophrenia. The study had a non-randomized, quasi-experimental design including a pretest, post-test, and follow-up test. It was conducted with 36 patients with schizophrenia (n = 18 intervention group, n = 18 control group) who regularly visited a Community Mental Health Center (CMHC) in Türkiye and participated voluntarily. The EREP was applied to the intervention group for eight weeks. "Personal Information Form", "Emotion Expression Scale (EES)", "Toronto Alexithymia Scale (TAS)", and "Positive Negative Syndrome Scale (PANSS)" were applied to all participants in the pretest, post-test, and follow-up test. The follow-up test was applied one month after the end of the sessions. Number, percentage, chi-square test, and repeated measures analysis of variance were used for data evaluation. In the total alexithymia score, there was a significant difference in the group interaction by time in the intervention group compared to the control group. In terms of total alexithymia score, the post-test and follow-up test mean scores of the intervention group were lower than the control group (p < 0.05; η2 = 0.122). There was a significant time*group interaction in the positive emotion subscale of the EES (p < 0.05; η2 = 0.121). The findings of our study indicated that the EREP had a positive effect on the alexithymia scores of patients with schizophrenia. We found that the EREP used in our study contributed to the reduction of alexithymia levels in patients with schizophrenia.

P194 Health-related quality of life and fatigue in newly-diagnosed inflammatory bowel diseases: findings from a prospective population-based inception cohort, IBD Prognosis Study

Abstract Background Patients with inflammatory bowel diseases (IBD) often experience impaired quality of life (QoL) and fatigue. In the current study, we aimed to investigate QoL and fatigue at the time of IBD diagnosis and determine their association with the disease presentation. Methods Incident adult patients (≥18 years old) with newly diagnosed ulcerative colitis (UC) or Crohn’s disease (CD) according to the Copenhagen IBD Criteria were included in the IBD Prognosis Study, a prospective, population-based, inception cohort representing approximately 20% of the Danish population (1.1 million). QoL was assessed using EQ-5D-5L and Short inflammatory Bowel Disease Questionnaires (SIBDQ), while fatigue was assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale. A severe disease presentation was defined by the need for glucocorticoids, immunomodulators, biologics, or surgery within three months of disease. Multivariable logistical regression analyses were conducted by adjusting for gender, age, and disease phenotype. Results Out of the original cohort, 203 (65.9%) and 116 (57.7%) patients with incident UC and CD, respectively, responded to the questionnaires without differences between responders and non-responders. The mean EQ-5D-5L index values were significantly lower in patients with UC (0.82, SD 0.17) and CD (0.79, SD 0.23), compared to the Danish background population (both p&amp;lt;0.001). The difference between UC and CD was also statistically significant (p&amp;lt;0.001). Further, more than every third of patients reported severely reduced SIBDQ (UC 29.6%, CD 43.1%, p=0.04). Severe fatigue was experienced frequently at the diagnosis (UC 26.1%, CD 30.2%, p=0.43), and was more common compared to the control group (means: UC 37.2 (SD 12.0), CD 35.3 (SD 11.5), control group: p&amp;lt;0.001). Female gender and extensive UC were independently associated with severely impaired SIBDQ and fatigue in patients with UC, while EIMs were associated with both outcomes in UC and CD (Table 1). Finally, severely reduced SIBDQ and severe fatigue were independently associated with a severe disease presentation, as well as IBD-related hospitalization specifically, in both UC and CD (Figure 1). Conclusion In this prospective population-based inception cohort of newly diagnosed IBD, we found a high proportion of patients with severely impaired generic QoL, SIBDQ, and fatigue compared to healthy controls. This study emphasizes the importance of addressing these negative symptoms in patients with IBD and their prognostic impact on the disease presentation. Ref: 1. Jensen MB et al., Scand J Public Health. 2023. doi: 10.1177/14034948211058060. 2. Montan I et al., Value Health. 2018. doi: 10.1016/j.jval.2018.03.013.

Impact of cognitive reserve in clinical, neurocognitive and lifestyle factors in patients with first-episode of psychosis and schizophrenia

IntroductionAlthough there is evidence that higher cognitive reserve (CR) is a protective factor and it has been related to better prognosis, there have been no studies to date that have explored the CR level and its impact in clinical, neurocognitive and lifestyle outcomes according to the stage of the disease: early stage of psychosis (ESP) or chronic schizophrenia (SCZ). Material and methodsA total of 60 patients in the ESP and 225 patients with SCZ were enrolled in the study. To test the predictive capacity of CR for each diagnostic group, a logistic regression analysis was conducted. Hierarchical linear regression analyses were performed to explore the associations between CR and different outcomes. The mediation analyses were performed according to the principles of Baron and Kenny. ResultsPatients with SCZ showed lower CR than those in the ESP (p<0.001). CR correctly classified 79.6% of the cases (p<0.001; Exp(B)=1.062). In ESP group, CR was related to working memory (p=0.030) and negative symptoms (p=0.027). CR (t=3.925, p<0.001) and cannabis use (t=2.023, p=0.048) explained 26.7% of the variance on functioning (p=0.003). In patients with SCZ, CR predicted all cognitive domains, negative symptoms (R2=0.091, p=0.001) and functioning (R2=0.074, p=0.005). In both ESP and SCZ groups, higher CR was associated with lower body mass index and circumference. In ESP group, the effect of adherence to Mediterranean diet on functioning (p=0.037) was mediated by CR level (p=0.003). ConclusionsThe implications of CR depend on the stage of the disease (ESP vs. SCZ), with a greater effect on neurocognition and negative symptoms in patients with chronic SCZ.

CLINICAL-PSYCHOPATHOLOGICAL ANALYSIS OF THE STRUCTURE AND EXPRESSION OF NEGATIVE AND POSITIVE SYMPTOMS IN PATIENTS WITH SCHIZOPHRENIA

The aim: to determine the features of the clinical-psychopathological structure and severity of negative and positive symptoms in patients with schizophrenia to improve diagnosis and treatment of schizophrenia.&#x0D; Materials and methods. 252 patients with negative symptoms (NS) in schizophrenia and 79 patients with positive symptoms (PS) in schizophrenia were examined. The research used a comprehensive approach, which consisted in the use of clinical-psychopathological, psychometric (PANSS scale) and statistical research methods.&#x0D; Results. Manifestations of positive symptoms in patients with NS in schizophrenia were mainly delineated by delusions of a minimal and weak level; minimal manifestations of delirium, unusual behavior and thought disorders; the predominance of patients with no disorders, minimal disorders and a weak level of disorders of hallucinatory behavior, excitement, ideas of grandeur, suspiciousness, and hostility. Manifestations of negative symptoms in patients with NS in schizophrenia were characterized by a predominance of medium and severe levels of blunted affect; moderate and average levels of emotional alienation; violation of abstract thinking of a weak and moderate level; average level of impaired fluency and spontaneity of speech; moderate communication impairment; passive-apathetic social detachment of the average level.&#x0D; Among patients with PS in schizophrenia, the manifestations of positive symptoms were mainly delineated by delusions of medium and strong levels of severity; moderate and pronounced manifestations of delirium; a moderate level of severity of thinking disorders and unusual behavior; predominance of moderate, medium and strong levels of expression of hallucinatory behavior, excitement, ideas of grandeur, suspicion and hostility. Manifestations of negative symptoms in patients with PS in schizophrenia were characterized by a predominance of a minimal level of expression of dulled affect, social exclusion and impaired fluency and spontaneity of speech; minimal and weak levels of emotional alienation; average level of communication disorders and abstract thinking.&#x0D; Conclusions. Features of the clinical-psychopathological structure and severity of negative and positive symptoms in patients with schizophrenia were established. The obtained data can serve as diagnostic criteria for conducting differential diagnosis and choosing treatment strategies for patients with schizophrenia.

Efficacy of Using Intermittent Theta Burst Stimulation to Treat Negative Symptoms in Patients with Schizophrenia-A Systematic Review and Meta-Analysis.

Negative symptoms in schizophrenia impose a significant burden with limited effective pharmacological treatment options. Recent trials have shown preliminary evidence for the efficacy of using intermittent theta burst stimulation (iTBS) in treating negative symptoms in schizophrenia. We aim to systematically review the current evidence of iTBS in the treatment of the negative symptoms of schizophrenia as an augmentation therapy. The study protocol was developed and registered on Prospero (registration ID: 323381). MEDLINE, EMBASE, Web of Science (Scopus), PsycINFO and Wan Fang databases were searched for sham-controlled, randomized trials of iTBS among patients with schizophrenia. The mean difference in major outcome assessments for negative symptoms was calculated. The quality of evidence was assessed using the Cochrane Risk of Bias Tool (version 1) and the GRADE system. Moreover, 12 studies including a total of 637 participants were included. Compared to sham treatment, the pooled analysis was in favor of iTBS treatment for negative symptoms (mean weight effect size: 0.59, p = 0.03) but not for positive symptoms (mean weight effect size: 0.01, p = 0.91) and depressive symptoms (mean weight effect size: 0.35, p = 0.16). A significant treatment effect was also observed on the iTBS target site left dorsal prefrontal cortex (mean weight effect size: 0.86, p = 0.007) and for stimulation with 80% motor threshold (mean weight effect size: 0.86, p = 0.02). Thus, our synthesized data support iTBS as a potential treatment for negative symptoms among patients with schizophrenia. However, the long-term efficacy and safety issues of iTBS in a larger population have yet to be examined.

Phenomenological assessment of the features of negative symptoms in patients with schizophrenia

The purpose of the study is to assess the severity of negative symptoms in patients with schizophrenia in order to improve the diagnosis and treatment of this category of patients.Material and methods. 252 patients with negative symptoms of schizophrenia (main group) and 79 patients with positive symptoms of schizophrenia (comparison group) were examined. A total of 331 patients with schizophrenia took part in the study. A comprehensive approach was used in the study, consisting of a combination of clinical-psychopathological, psychometric (SANS scale) and statistical research methods.Research results. Clinical-psychopathological characteristics of patients with negative symptoms in schizophrenia have been established, which consisted of the predominance of the residual form of schizophrenia; continuously progradient and episodic with an increasing defect of flow types; the onset of negative symptoms in the initial period. Specific features of the manifestation of negative symptoms in patients with negative symptoms in schizophrenia have been determined, which consisted of the severity of attention disorders, anhedonia, abulia, and alogia. It has been detected that the phenomenology of negative symptoms in schizophrenia has a complex structure and is described by the presence of components of affective flattening (reduced expressiveness of speech, avoidance of eye contact), alogia (delayed responses, interrupted thoughts), abulia and apathy (reduced productivity and energy potential), anhedonia and antisociality (reduced activity in free time, sexual interests, the ability to feel intimacy and closeness) and the sphere of attention (reduced attentiveness in contact with others and during testing). Conclusions. As a result of the study, the peculiarities of the manifestation of negative symptoms in patients with negative symptoms of schizophrenia have been determined, which can act as diagnostic criteria and predictors of the formation of negative symptoms during the differential diagnosis of patients with schizophrenia and can be taken into account when creating treatment and psycho-corrective programs aimed at reducing negative symptoms in patients with schizophrenia.

Сariprazine in the treatment of schizophrenia spectrum disorders in a hospital setting

The aim of the study was to evaluate the possibility of using cariprazine for the treatment of productive and negative symptoms in schizophrenic spectrum disorders in a hospital setting.Materials and methods: A group of 35 patients with leading productive and negative symptoms in patients with schizophrenic spectrum disorders treated in a psychiatric hospital constituted the material of the study. The condition of patients was objectified according to the Clinical Global Impression Scale (CGI-S and CGI-I) and the Positive and Negative Syndrome Scale (PANSS) — at the beginning of the study and in dynamics on the 30th and 60th day of treatment. The mean PANSS score at the beginning of the study was 94.45±14.49 points. After the drug administration, the patients were followed up for up to 60 days.Results: Cariprazine was administered both as first-line treatment and after prior therapy. The dose range was from 1.5 mg to 6 mg daily. In 3 patients (8.57%), cariprazine therapy was discontinued due to the development of adverse events or worsening of the condition. The remaining 32 patients (91.43%) showed positive dynamics.Conclusions: The study showed high efficacy of cariprazine when administered for the treatment of productive and negative symptoms in schizophrenic spectrum disorders in a hospital setting. The drug was well tolerated in the majority of patients.

Dynamics of mental state and prolactin levels in patients with chronic schizophrenia during aripiprazole therapy

Introduction. Although scientific literature demonstrates a relationship between prolactin levels, the efficacy of aripiprazole therapy, and negative symptoms in patients with schizophrenia, many questions regarding these problems remain controversial.Objective to study dynamics of clinical and hormonal parameters in patients with chronic schizophrenia during aripiprazole therapy.Materials and methods: 60 patients with schizophrenia were studied: 42 male (70%) and 18 female (30%), aged 20 to 65 years (mean age 52.84±17.40 years) on inpatient aripiprazole treatment with the mean daily dosage of 15.33±4.52 mg. Comparative analysis of prolactin parameters was carried out taking into account the following factors: effectiveness of therapy, age, duration of the disease, severity of negative symptoms (according to the PANSS scores). Responders included patients with a reduction in total PANSS score of 20% and more.Results: the effectiveness of aripiprazole monotherapy after switching from previous antipsychotic treatment in patients with chronic schizophrenia was noted in 71.7% of patients. The effectiveness of therapy does not depend on the background values of the hormone: at high rates, prolactin levels decrease, and at low rates, they increase. Meanwhile, a certain pattern was revealed between the dynamics of scores of the negative PANSS scale and the level of prolactin: responders with high background levels showed the decrease of prolactin levels given the decline of the PANSS scores, and in responders with low values, the hormone levels increased. In non-responders, low background scores of the negative scale and their slight changes during therapy were accompanied by an increase in prolactin levels. The data obtained in relation to non-responder patients who showed negative correlations between the levels of prolactin, age, dosage of the drug and the duration of the disease require a more careful attitude to the appointment of aripiprazole due to the likelihood of a decrease in their prolactin levels to abnormally low values.

Clonidine augmentation reduces negative symptoms in patients with schizophrenia

Clonidine augmentation reduces negative symptoms in patients with schizophrenia

Investigation of momentary negative symptoms in patients with early psychosis in daily life: An experience sampling study

Negative symptoms are a key therapeutic target in promoting functional recovery in early psychosis intervention, but momentary negative symptom manifestations remain understudied in the early stage of illness. We employed an experience-sampling methodology (ESM) to evaluate momentary affective experiences, hedonic capacity for an event recalled, current activities and social interactions, and associated appraisals for 6 consecutive days in 33 clinically-stable early psychosis patients (within 3 years of treatment for first-episode psychosis) and 35 demographically-matched healthy controls. Adjusted multilevel linear-mixed models revealed higher intensity and variability of negative affect in patients than controls, but no group difference in affect instability as well as positive affect intensity and variability. Patients demonstrated no significantly greater anhedonia for event, activity or social interactions relative to controls. Higher preference for company (when alone) and to be alone (when in company) was observed in patients than controls. No significant group difference in pleasantness to be alone or proportion of time being alone. Our results indicate no evidence for blunting of affective experiences, anhedonia (social and non-social) and asociality in early psychosis. Future research complementing ESM with multiple digital phenotyping measures will facilitate more refined negative symptom assessment in the daily life of patients with early psychosis.

Effects of low-dose combined olanzapine and sertraline on negative and depressive symptoms in treatment-resistant outpatients with acute exacerbated schizophrenia.

Background: Treatment-resistant schizophrenia (TRS) is a major clinical challenge. Current antipsychotic medications do not adequately address negative and depressive symptoms in patients with TRS, and novel treatments are thus needed. This study examines the efficacy of low-dose combined olanzapine (OLA) and sertraline on depressive and negative symptoms in patients with TRS. Methods: A total of 34 TRS outpatients with acutely exacerbated schizophrenia were randomly assigned to OLA monotherapy (12.5-20mg/day) (control group) or low-dose combined OLA (7.5-10mg/day) and sertraline (50-100mg/day) (OS group). Clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) at baseline and at the end of treatment in weeks 4, 8, 12, and 24. Depressive symptoms and social functioning were also assessed. Results: Compared to the control group, the OS group showed significant improvements in depressive and negative symptoms over time. In addition, the low-dose combination of OLA and sertraline significantly improved social functioning compared with OLA monotherapy. There were no significant between-group differences in psychotic symptom improvement. However, the reduction in Hamilton Depression Rating Scale total score and PANSS negative subscore were not associated with improvements in social functioning, suggesting that these effects of combined treatment are independent. Conclusion: Low-dose combined OLA and sertraline may be effective in the treatment of negative and depressive symptoms compared with standard OLA monotherapy in patients with TRS who are experiencing an acute exacerbation of schizophrenia. Clinical Trial Registration: [ClinicalTrials.gov], identifier [NCT04076371].

Is there a Relationship Between Caffeine Intake and Smoking and Positive and Negative Symptom Severity in Schizophrenia?

It has been reported that caffeine intake and smoking are more frequent in patients with schizophrenia than the general population. However, the cause of high caffeine and smoking and its correlation with positive and negative symptoms is unclear. Therefore, the aim of the present study is to evaluate the correlation between daily caffeine intake and smoking and the severity of positive and negative symptoms in patients with schizophrenia. This study included 177 participants, 89 of whom were healthy controls and 88 patients with schizophrenia. Scale for the Assessment of Positive Symptoms (SAPS) and Scale for the Assessment of Negative Symptoms (SANS) scales were applied to the patients with schizophrenia to measure the severity of positive and negative symptoms of the disease. The amounts of caffeine and tobacco consumption were significantly higher in the patients group than healthy controls (p=0.001 and p<0.001, respectively). There was no significant correlations between daily caffeine consumption and SAPS or SANS scores in patients with schizophrenia. There was a significant positive relationship between SAPS-delusions score and tobacco consumption. Our study is the first study in the literature that examines the relationship between caffeine and cigarette intake and SANS and SAPS scales in patients with schizophrenia. Although caffeine intake is higher in patients with schizophrenia than healthy controls, this study is valuable as it shows that it is not associated with symptom severity. In addition, although it is known that smoking is high in patients with schizophrenia, this study showed a positive relationship between SAPS-delusion scores and tobacco consumption.

DIAPASON Project - sleep-wake patterns and their associations with the negative symptoms in patients with schizophrenia spectrum disorders

DIAPASON Project - sleep-wake patterns and their associations with the negative symptoms in patients with schizophrenia spectrum disorders

Validity and reliability of a Chinese version of the self-evaluation of negative symptoms.

The negative symptoms of schizophrenia can be present at any clinical stage, but evaluating the negative symptoms always remains challenging. To screen the negative symptoms effectively, self-evaluation should be introduced. To date, professional psychiatrists used almost all of the scales available to screen the negative symptoms but could not obtain an accurate outcome. At the same time, an advanced self-assessment scale is needed to accompany the patients' self-feeling-based treatment strategies to understand their feelings about their symptoms. Hence, Chinese self-evaluation of negative symptoms (SNS) should be introduced in China. This study aims to examine the validity and reliability of the Chinese version of SNS. Two hundred patients with schizophrenia were included in this study and were evaluated entirely with the self-assessed negative symptoms by the Chinese version. The correlation analysis was performed between SNS and the Scale for Assessment of Negative Symptoms (SANS) to assess the criterion validity of SNS for screening negative symptoms. Exploratory factor analysis was used to determine the constructive validity of the SNS. Two senior professional psychiatrists were involved in this assessment based on their clinical experience and capability to define the severity of the negative symptoms. Receiver operating characteristic curve (ROC) analysis was performed to assess the cutoff point of SNS. Cronbach's alpha coefficient and intraclass correlation (ICC) coefficient were used to determine the reliability of SNS. We have the following findings: The Chinese version of SNS demonstrated a significant correlation with the SANS (r=.774, p<.05). Exploratory factor analysis demonstrated that the factor loading varies from .442 to .788. ROC analysis demonstrated that at SNS≥8, the patients demonstrated a mild severity of negative symptoms, and at SNS≥15, the patients demonstrated a severe severity of negative symptoms. Subsequently, 9<SNS<14 was defined as a moderate severity of negative symptoms. The Cronbach's alpha and ICC coefficients of the Chinese version SNS were .877 and .774, respectively. Our results showed that the acceptable validity and reliability of the Chinese version of SNS confirmed that SNS is an ideal tool for self-assessment of the negative symptoms in patients with schizophrenia.