Prevalence Of Negative Symptoms Research Articles

Negative symptoms in children and adolescents with early-onset psychosis and at clinical high-risk for psychosis: systematic review and meta-analysis.

Early-onset psychosis (EOP) refers to the development of a first episode of psychosis before 18 years of age. Individuals at clinical high risk for psychosis (CHR-P) include adolescents and young adults, although most evidence has focused on adults. Negative symptoms are important prognostic indicators in psychosis. However, research focusing on children and adolescents is limited. To provide meta-analytical evidence and a comprehensive review of the status and advances in the diagnosis, prognosis and treatment of negative symptoms in children and adolescents with EOP and at CHR-P. PRISMA/MOOSE-compliant systematic review (PROSPERO: CRD42022360925) from inception to 18 August 2022, in any language, to identify individual studies conducted in EOP/CHR-P children and adolescents (mean age <18 years) providing findings on negative symptoms. Findings were systematically appraised. Random-effects meta-analyses were performed on the prevalence of negative symptoms, carrying out sensitivity analyses, heterogeneity analyses, publication bias assessment and quality assessment using the Newcastle-Ottawa Scale. Of 3289 articles, 133 were included (n = 6776 EOP, mean age 15.3 years (s.d. = 1.6), males = 56.1%; n = 2138 CHR-P, mean age 16.1 years (s.d. = 1.0), males = 48.6%). There were negative symptoms in 60.8% (95% CI 46.4%-75.2%) of the children and adolescents with EOP and 79.6% (95% CI 66.3-92.9%) of those at CHR-P. Prevalence and severity of negative symptoms were associated with poor clinical, functional and intervention outcomes in both groups. Different interventions were piloted, with variable results requiring further replication. Negative symptoms are common in children and adolescents at early stages of psychosis, particularly in those at CHR-P, and are associated with poor outcomes. Future intervention research is required so that evidence-based treatments will become available.

Negative symptoms and associated factors in older people with schizophrenia

IntroductionThe evolution of schizophrenia with age remains poorly studied. The prevalence of negative symptoms in elderly people with schizophrenia is even less described in the literature.Objectivesto evaluate the prevalence of remission of negative symptoms in the elderly and to study the sociodemographic and clinical variables associated with this remission.MethodsThe sample consisted of 83 subjects aged 55 years and over, followed at the psychiatry department "G" of the Razi hospital in Tunis and suffering from schizophrenia according to the DSM5 criteria. Global remission was defined as a score below 4 on the seven negative symptom items of the PANSS. A questionnaire was administered to each patient to collect epidemiological and anamnestic data.Results59% of the sample showed remission of global negative symptoms. 84% and 60% were in remission on the emotional and cognitive subscales, respectively. The existence of remission was correlated with lower PANSS global score, more preserved cognitive functioning, later age of onset, more family and social support, and the absence of a concomitant somatic illness.ConclusionsThis study showed that measures to optimize treatment of positive symptoms and cognitive functioning may have an impact on negative symptoms. Similarly, quality of social network in later life impacts the level of negative symptoms.Disclosure of InterestNone Declared

КОМПЛЕКСНОЕ ЛЕЧЕНИЕ РЕЗИСТЕНТНОЙ ФОРМЫ ШИЗОФРЕНИИ, ПРЕИМУЩЕСТВЕННО, С НЕГАТИВНЫМИ СИМПТОМАМИ

В статье представлена проблема резистентной шизофрении и негативной симптоматики. В теоретическом и практическом аспекте описаны попытки и возможности современной фармакотерапии преодолеть данный феномен. The article presents the problem of resistant schizophrenia and negative symptomatology. In theoretical and practical aspect the attempts and possibilities of modern pharmacotherapy to overcome this phenomenon are described. Modern research demonstrates that there are no obvious pathological changes in the brain of persons with schizophrenia. Nevertheless, there is evidence that a neurodegenerative process (significant ventricular dilation, decreased cortical thickness, decreased activity according to functional imaging techniques, and a more malignant course of the disease) may underlie the prevalence of negative symptoms in schizophrenia. Based on data from this and other studies (particularly in Alzheimer's disease), the authors concluded that cerebral as an adjunctive therapy can improve cognitive function in patients with schizophrenia and predominantly negative symptoms. However, the mechanism of this therapeutic effect remains unclear. It should be noted that olanzapine (ferzapine) monotherapy also improves cognitive function in individuals with schizophrenia [9].Safety. No serious adverse events were noted in any group during the study. The most frequent adverse events, which developed in at least 10% of patients in each group, were changes regarding weight gain. The addition of 20 mL of cerebral to olanzapine (ferzapine) at doses of 5-10 mg/day was safe and well tolerated by the subjects.This study had some limitations that should be taken into account when interpreting the results. First, only those patients who had more negative than positive symptoms were included in the follow up because they were less sensitive to antipsychotics. In addition, a study with a larger patient population and different clinical characteristics should be conducted to clarify whether cerebral therapy itself is effective in reducing the severity of schizophrenia symptoms. Second, this study was conducted over a relatively short 8-week period, which is too short to realize the full therapeutic effect of cerebral. Although additional effects of cerebral on memory and other cognitive functions were noted beginning in the 2nd week of treatment, it may take longer to detect an obvious effect on negative symptoms. Only a fixed dose of cerebral was used in all patients. Although cerebral at a dose of 20 ml/day does not increase the therapeutic effcacy of olanzapine (ferzapine) in the treatment of positive and negative symptoms in schizophrenia, the results of this study suggest that it may improve cognitive function. A similar effect has been observed in the treatment of other neurological disorders. Thus, in our opinion, there is a very interesting prospect for further randomized studies combining olanzapine (ferzapine) with nootropic drugs, in particular cerebral. Further studies with different doses of cerebral over a longer period of time are needed.

Self-evaluation of negative symptoms in adolescent and young adult first psychiatric episodes

BackgroundNegative Symptoms (blunted affect, alogia, anhedonia, avolition, and asociality) are usually described in schizophrenia but they are also present in other psychiatric disorders. The diagnosis and prognosis relevance of negative symptoms (NS) self-assessment during a first psychiatric episode is still unknown. AimsTo determine (i) the rate of self-assessed NS in a first psychiatric episode among adolescents and young adults compared to control subjects; and (ii), whether there is a difference in the prevalence of NS between schizophrenia and major depressive disorder first episodes. MethodsThe population included patients aged 15–25 years, with no psychiatric history and no history of medication. A dimensional evaluation was assessed during hospitalization, including depressive (Hamilton Depression Scale), psychotic symptoms (Prodromal Questionnaire, 16 items) and the self-evaluation of negative symptoms (SNS scale). Prospective categorical diagnoses were updated 6 months after hospitalization. The population included 117 individuals (58 patients and 59 healthy controls). ResultsAmong healthy individuals, 47.5% reported at least one NS, the most reported being amotivation. After binary logistic regression, Negative Symptoms (SNS score) were associated with a diagnostic of psychiatric disorder at the 6-months follow-up (OR = 1.163, p = .001), whereas depressive symptoms and psychotic experiences were not. A SNS threshold allowed to screen first episode patients and SZ patients in the general population (assessed with ROC curve). A high prevalence of self-reported NS was observed across diagnostic boundaries in first psychiatric episodes, with a mean SNS score of 19.3 ± 7.1 for schizophrenic disorders and 20.7 ± 8.6 for depressive disorders. The prevalence of NS was not significantly different between depressive disorders and schizophrenic disorders (p > .05). ConclusionNS are an important transnosographic dimension during first psychiatric episodes among adolescents and young adults. Negative symptoms self-assessment with the SNS scale is relevant during a first psychiatric episode.

Peculiarities of clinical development of schizophrenia with comorbid somatic disorders.

In order to identify the clinical features of schizophrenia associated with somatic diseases, 186 patients with schizophrenia (50 patients with schizophrenia with cardiovascular diseases, 42 patients with schizophrenia with type 2 diabetes, 44 patients with schizophrenia with obesity and 50 patients with schizophrenia without chronic somatic diseases) were surveyed. Socio-demographic, clinical-dynamic and clinical-psychopathological features of schizophrenia (according to PANSS scale), connected with somatic diseases in a comparative aspect with patients with schizophrenia without somatic pathology were studied. It was found that somatic pathology combined with schizophrenia aggravates psychopathological symptoms, modifies clinical manifestations of schizophrenia and is associated with decrease in the level of social realization of patients, increase in the number of hospitalizations and a significant course of psychotic process. Among clinical features of schizophrenia with somatic disorders there was defined: in cardiovascular diseases - the presence of hallucinatory behavior, hypochondrial ideas and anxiety-depressive symptoms; in type 2 diabetes - hallucinatory activity in combination with excitement, impulsivity, hypochondrial ideas, depressive symptoms, and attention deficit, in obesity - the prevalence of negative symptoms over positive, expressed social rejection, depletion of social contacts and the presence of depressive experiences.

Negative Symptoms in Early-Onset Psychosis and Their Association With Antipsychotic Treatment Failure.

The prevalence of negative symptoms (NS) at first episode of early-onset psychosis (EOP), and their effect on psychosis prognosis is unclear. In a sample of 638 children with EOP (aged 10–17 y, 51% male), we assessed (1) the prevalence of NS at first presentation to mental health services and (2) whether NS predicted eventual development of multiple treatment failure (MTF) prior to the age of 18 (defined by initiation of a third trial of novel antipsychotic due to prior insufficient response, intolerable adverse-effects or non-adherence). Data were extracted from the electronic health records held by child inpatient and community-based services in South London, United Kingdom. Natural Language Processing tools were used to measure the presence of Marder Factor NS and antipsychotic use. The association between presenting with ≥2 NS and the development of MTF over a 5-year period was modeled using Cox regression. Out of the 638 children, 37.5% showed ≥2 NS at first presentation, and 124 (19.3%) developed MTF prior to the age of 18. The presence of NS at first episode was significantly associated with MTF (adjusted hazard ratio 1.62, 95% CI 1.07–2.46; P = .02) after controlling for a number of potential confounders including psychosis diagnostic classification, positive symptoms, comorbid depression, and family history of psychosis. Other factors associated with MTF included comorbid autism spectrum disorder, older age at first presentation, Black ethnicity, and family history of psychosis. In EOP, NS at first episode are prevalent and may help identify a subset of children at higher risk of responding poorly to antipsychotics.

SA52. The Prevalence of Negative Symptoms Across the Stages of the Psychosis Continuum

SA52. The Prevalence of Negative Symptoms Across the Stages of the Psychosis Continuum

Local and Widely Distributed EEG Activity in Schizophrenia With Prevalence of Negative Symptoms.

We evaluated EEG frequency abnormalities in resting state (eyes closed and eyes open) EEG in a group of chronic schizophrenia patients as compared with healthy subjects. The study included 3 methods of analysis of deviation of EEG characteristics: genuine EEG, current source density (CSD), and group independent component (gIC). All 3 methods have shown that the EEG in schizophrenia patients is characterized by enhanced low-frequency (delta and theta) and high-frequency (beta) activity in comparison with the control group. However, the spatial pattern of differences was dependent on the type of method used. Comparative analysis has shown that increased EEG power in schizophrenia patients apparently concerns both widely spatially distributed components and local components of signal. Furthermore, the observed differences in the delta and theta range can be described mainly by the local components, and those in the beta range mostly by spatially widely distributed ones. The possible nature of the widely distributed activity is discussed.

A study on negative and depressive symptom prevalence in individuals at ultra‐high risk for psychosis

Negative symptoms are known to be present in the prodromal stage of psychotic disorders, yet little is known about their prevalence. Studies examining the presence of negative symptoms in ultra-high risk (UHR) populations have shown some limitations, notably failing to control depression. The objective of this study was to examine the prevalence of negative symptoms in the presence of significant levels of depression and in the absence of such symptoms (primary negative symptoms) over 1 year and to examine differences in negative symptoms in psychosis converters and non-converters. Participants were 123 individuals at UHR for the development of psychosis receiving follow-up for a period of 2 years. Negative symptoms and depression were measured using the Scale for the Assessment of Negative Symptoms and the Montgomery-Asberg Depression Scale at baseline, 6 and 12 months post-admission. At baseline, the prevalence of negative symptoms and primary negative symptoms was 76.4% and 32.7%, respectively. Whereas the prevalence of negative symptoms was significantly decreased at 6 months, the prevalence of primary negative symptoms was similar at all time points. Negative symptoms at baseline were not different between later converters and non-converters to psychosis. Our findings confirm the presence of secondary and primary negative symptoms in individuals at UHR, but suggest a differential trajectory of both measures over time. Future studies should include larger UHR groups and focus on the investigation of intra-individual changes in primary negative symptoms over time and further explore their potential role for psychosis conversion.

Has the prevalence, clinical presentation and social functioning of schizophrenia changed over the last 25 years? Nithsdale schizophrenia survey revisited

BackgroundMajor changes in the treatment of schizophrenia have taken place in recent years, including a shift from inpatient to community care, and the introduction of second-generation antipsychotics and psychosocial interventions. Recent evidence has questioned the superiority of these interventions over older treatments. AimsWe wished to ascertain the impact of changes in the treatment of schizophrenia in a geographically-defined area, focusing on clinical symptoms and psychosocial outcome. MethodsIn 2006, we replicated the survey carried out in 1981, identifying the population of people with schizophrenia living in Nithsdale, South-West Scotland, measuring prevalence using the ‘key informant’ method. We assessed their clinical and social functioning, using similar scales, and compared measures across both time periods. ResultsWe identified 205 people with schizophrenia, a point prevalence of 3.59/1000 general population. In 2006, while fewer people experienced negative symptoms, a greater number experienced positive symptoms. There were no significant differences in the prevalence of tardive dyskinesia or Parkinsonism, though tremor was less common in the 2006 population. In 2006, there were fewer people living with a spouse/partner or parents, and fewer were in open employment in comparison to the 1981 population. The overall level of social adjustment had not changed. ConclusionsThe clinical manifestation of schizophrenia appears to have changed over the last 25years, within this geographically-defined area, the prevalence of negative symptoms having decreased, and positive symptoms seem to have increased. The level of social functioning does not appear to have changed over the last 25years.

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.

Study of negatives symptoms in first episode schizophrenia

Background: Prevalence of negative symptoms in the early phase of schizophrenia remains uncertain. Negative symptoms are the primary cause of long term disability and poor functional outcome. The purpose of this study is to examine the presence of negative symptoms in patients with fist episode psychosis in schizophrenia who were hospitalized. Methods: Negative symptoms were measured in 72 patients presenting with FEP using the scale for assessment of negative symptoms (SANS) and ascertained diagnosis using DSM-IV. Prevalence of SANS items and subscales were examined for both schizophrenia and bipolar disorder. Results: This study shows that a significant number of patients with first episode schizophrenia had negative symptoms 66 (87.5%). All five subtypes of negative symptoms were present in 47% of patients suggesting primary negative symptoms, and about 40% have secondary negative symptoms. Independently, each subtype of negative symptoms was seen in 48% - 76% of patients. The most prevalent negative symptom in first-episode schizophrenia was found to be blunting (72%). 46% of patients had significant level of depression, overall psychopathology was severe and level of functioning was poor. We found that 45.8% patients were prescribed anticholinergic medications which indicated that at least 45% subjects had extra-pyramidal symptoms (EPS). Conclusion: Primary negative symptoms are prevalent in about half of First episode Psychosis (FEP) schizophrenia patients. These findings have implications for identification, early treatment, and reduced treatment resistance for negative symptoms in order to increase social and clinical outcome of schizophrenia. Further research is required in this area.

1654 – Efficacy of aripiprazole on behavioural symptoms in three young patients with severe acquired brain injury

The atypical antipsychotic drug aripirprazole has a partial agonist activity on the dopamine receptors. This characteristic makes aripiprazole different from other antipsychotic agents. In this paper, we aim to describe the use of this drug in the management of three young patients with acquired brain injury: a woman with Wilsons disease, a male with a rupture of an arteriovenous malformation and a male with severe traumatic brain injury. All patients presented behavioural symptoms. One of them presented frequent crises of psychomotor agitation with strong physical aggressive reaction, partial awareness and low frustration tolerance. The other two patients reported a prevalence of negative symptoms, as inactivity, apathy, lack of will and severe perseveration. They were referred to our Unit and were evaluated with a full functional assessment at the moment of admission and at the discharge, depending on their clinical picture. The evaluation included: MMSE (Mini Mental State Examination), LCF (Level of Cognitive Functioning), DRS (Disability Rating Scale) and FIM (Functional Independence Measure). The behavioural assessment was made with clinical interviews. After the introduction of aripiprazole, we found an improvement in the behavioural pattern, moreover neuropsychological and motor evaluation appeared not affected. These results suggest that the use of aripiprazole in patients with acquired brain injury is suitable for its efficacy in reducing psychotic and behavioural symptoms but also for its potential for not affecting motor and cognitive functioning.

Prevalence of Negative Symptoms and Associated Factors in Older Adults With Schizophrenia Spectrum Disorder

Prevalence of Negative Symptoms and Associated Factors in Older Adults With Schizophrenia Spectrum Disorder

Prevalence of Negative Symptoms in Outpatients With Schizophrenia Spectrum Disorders Treated With Antipsychotics in Routine Clinical Practice: Findings From the CLAMORS Study

Prevalence of Negative Symptoms in Outpatients With Schizophrenia Spectrum Disorders Treated With Antipsychotics in Routine Clinical Practice: Findings From the CLAMORS Study

Prevalence of Negative Symptoms in Outpatients With Schizophrenia Spectrum Disorders Treated With Antipsychotics in Routine Clinical Practice

To analyze the prevalence of negative symptoms in antipsychotic-treated outpatients with schizophrenia spectrum disorders. A cross-sectional, retrospective multicenter study was carried out between May 2004 and April 2005 in 1,704 adult psychiatric outpatients meeting DSM-IV criteria for schizophrenia, schizophreniform, or schizoaffective disorder. We used 5 items of the Positive and Negative Syndrome Scale (PANSS) negative symptoms subscale to individually determine the presence of a negative symptom when the score on the item was > 3. Primary negative symptoms were considered present when patients fulfilled all of the following: > 3 score on the corresponding item; < 3 score on any positive item; no extrapyramidal symptoms; <or= 3 score on anxiety and depression items; dose of haloperidol, when applicable, <or= 15 mg/d; and no antiparkinsonian treatment. A total of 1,452 evaluable patients (863 men, 60.9%), 40.7 +/- 12.2 (mean +/- SD) years of age, were included. One or more negative symptoms were present in 57.6% of patients, with primary negative symptoms in 12.9% of subjects. The most frequent negative symptom items were social withdrawal (45.8%), emotional withdrawal (39.1%), poor rapport (35.8%), and blunted affect (33.1%). Negative symptoms (1-blunted affect, 2-emotional withdrawal, 3-poor rapport, 4-social withdrawal, 5-verbal fluency) were most associated with maleness (symptom 4); age > 40/45 years (men/women; symptoms 1,2,4); single/unmarried status (symptoms 2-4); unemployment (symptoms 3,4); higher score on the Clinical Global Impressions (CGI) scale and PANSS total score (symptoms 1-5); lower score on the PANSS positive symptoms subscale (symptoms 1,3); more than 52 weeks of treatment (symptoms 1-3,5); and high antipsychotic dose (symptom 2). The prevalence of negative symptoms in patients with schizophrenia spectrum disorders treated with antipsychotics in routine clinical practice not only is still considerably high but also seems to be related to poorer functioning, unemployment, greater severity, and less positive symptomatology and higher antipsychotic dose.

Severity of negative symptoms in Schizophrenia correlated to Hyperactivity of the left globus pallidus and the right claustrum. A PET Study.

SummarySchizophrenia has been characterized as a complex disease, in which various cerebral regions may be affected. The purpose of this study was to compare the cerebral regions that are involved in mild and severe negative symptoms, and to determine whether the degree of severity can be related to specific dysfunctional areas of the brain.The PANS Scale was used to form two groups of patients with prevalence of negative symptoms: Mildly Affected (MA), and Severely Affected (SA). Brain PETs were obtained in resting conditions, and SPM (Statistical Parametric Mapping) was used to perform statistical comparisons.The MA-group showed increased activity in: posterior cingulate gyrus, middle frontal gyrus, precentral gyrus, middle occipital gyrus, cuneus and post-central gyrus; decreased activity in inferior frontal gyrus, orbitofrontal and fusiform gyrus.The SA-group showed increased activity in: globus pallidus, insular cortex, cuneus, claustrum, post-central gyrus and pre-central gyrus; decreased acti-vity in fusiform gyrus and superior temporal gyri. These results show correlation of negative symptomatology with abnormalities in the cortico-striato-pallido-thalamic neural circuit. Severity of negative symptoms is clearly correlated to abnormal left external pallidal activation, evidencing the relevance of this nucleus for cognitive, planning and social capabilities. Specific therapeutic strategies might be derived from pallidal neurotransmitter systems studies.

Effects of estrogen on brain development and neuroprotection—implications for negative symptoms in schizophrenia

Increasing evidence during the last few years suggests that there are gender-specific differences in schizophrenia, influencing the age of onset, treatment outcome and the prevalence of negative symptoms. With respect to the latter in postmortem brain and cerebrospinal fluid of schizophrenic patients with negative symptoms a reduction of dopaminergic activity became evident. Measures of noradrenergic activity, dopamine β-hydroxylase and the metabolite MHPG, appear to decrease with brain atrophy seen in patients with negative symptoms. Serotonergic activity tends to be low in patients with impaired cognitive function as is seen in negative schizophrenia. In these patients ventricular enlargement is associated with the severity of negative symptoms, low monoamine activity and low cerebral glucose metabolism. On the other hand atypical antipsychotic drugs that modulate also glutamate receptor activity, suggest an additional alternative mechanism of antipsychotic action beyond aminergic neurotransmitters. These drugs improve glutamatergic transmission and decrease negative symptoms; this suggests a glutamatergic deficiency as an extension of the dopamine model. The glutamate–dopamine interaction illustrates the importance of cross-talk between projections to the cortex, striatum, and lower brainstem for the expression of negative symptomatology. On the other hand, estradiol-17β the most potent female sex hormone influences not only primary and secondary sexual characteristics but also embryonal and fetal growth as well as development of the brain aminergic networks, which are involved in schizophrenia. Estradiol-l7β possesses neuroprotective properties, which are relevant for the course of schizophrenia and this may explain the pronounced gender differences with respect to progression and therapeutic response of schizophrenia. The present review attempts an update and synthesis of the information about the hormonal influence on neuronal pathways in negative symptoms of schizophrenia. It shows that estradiol-l7β influences transporters and receptors as well as the morphological appearance of neuronal systems and that it may be an integral part of the neuroprotective system ameliorating schizophrenia.

The TAPS Project. 10: The Long-Stay Populations of Friern and Claybury Hospitals: The Baseline Survey

As part of the TAPS project, the baseline long-stay populations of Friern and Claybury Hospitals were compared using the TAPS assessment schedules. Each hospital has reduced bed numbers by two-thirds, and although the two have been subjected to different influences, their remaining long-stay patients were similar, and characterised by severe problems with hygiene, florid psychotic symptoms, a high prevalence of negative symptoms, and impoverished social networks.