David Baxter PhD
Late Founder
Negative schizophrenia symptoms common despite treatment
By Lucy Piper, MedWire News
02 April 2010
J Clin Psychiatry 2010; 71: 280–286
A high number of patients with schizophrenia or schizophrenia spectrum disorders continue to experience negative symptoms despite receiving antipsychotic treatment, findings from the CLAMORS study show.
“We consider this to be a source of concern for public health,” say Julio Bobes, University of Oviedo in Asturias, Spain, and colleagues.
They stress that not only is the prevalence of these symptoms high, but also their presence has an adverse impact on patients’ functioning, employment status, and illness severity.
Negative symptoms are intrinsic to the pathology of schizophrenia, but the search for effective medications has been hampered by difficulties in defining and measuring them.
For the CLAMORS (Cardiovascular, Lipid, and Metabolic Outcomes Research in Schizophrenia) study, 1704 adults with schizophrenia, schizophreniform, or schizoaffective disorder were recruited. All the patients were receiving antipsychotics most frequently used in daily practice, including five different second generation antipsychotics and one classic antipsychotic, for at least 12 weeks.
The presence of negative symptoms was determined using five items of the Positive and Negative Syndrome Scale (PANSS) negative symptoms subscale. Negative symptoms were considered present if the score on the item was above 3.
Primary negative symptoms were considered present if the score on the corresponding negative symptom item was above 3; the score on any positive symptoms item was below 3; the patient had no extrapyramidal symptoms; scores on anxiety and depression items were 3 or below; dose of haloperidol, when applicable, was 15 mg/day or below; and the patient was not taking antiparkinsonian treatment.
The study findings showed that 57.6% of patients had at least one negative symptom, while 12.9% of patients had primary negative symptoms.
The most frequent negative symptoms were social withdrawal (45.8%), emotional withdrawal (39.1%), poor rapport (35.8%), and blunted affect (33.1%).
Furthermore, these symptoms were significantly associated with unemployment, higher Clinical Global Impressions (CGI) scale and PANSS total scores, lower scores on the PANSS positive symptoms subscale, more than 52 weeks of treatment, and high antipsychotic dose.
“Increasing our understanding of the variables associated with negative symptoms in this vulnerable population may help to establish preventing and therapeutic programs for higher risk groups,” say Bobes and team in the Journal of Clinical Psychiatry.
“Improving our methods for measuring these devastating symptoms, coupled with the ongoing development of novel antipsychotic agents, may fuel renewed interest in the evaluation of negative symptoms and optimism that better treatments for negative symptoms can be found."
Source: J Clin Psychiatry / Document Archive
By Lucy Piper, MedWire News
02 April 2010
J Clin Psychiatry 2010; 71: 280–286
A high number of patients with schizophrenia or schizophrenia spectrum disorders continue to experience negative symptoms despite receiving antipsychotic treatment, findings from the CLAMORS study show.
“We consider this to be a source of concern for public health,” say Julio Bobes, University of Oviedo in Asturias, Spain, and colleagues.
They stress that not only is the prevalence of these symptoms high, but also their presence has an adverse impact on patients’ functioning, employment status, and illness severity.
Negative symptoms are intrinsic to the pathology of schizophrenia, but the search for effective medications has been hampered by difficulties in defining and measuring them.
For the CLAMORS (Cardiovascular, Lipid, and Metabolic Outcomes Research in Schizophrenia) study, 1704 adults with schizophrenia, schizophreniform, or schizoaffective disorder were recruited. All the patients were receiving antipsychotics most frequently used in daily practice, including five different second generation antipsychotics and one classic antipsychotic, for at least 12 weeks.
The presence of negative symptoms was determined using five items of the Positive and Negative Syndrome Scale (PANSS) negative symptoms subscale. Negative symptoms were considered present if the score on the item was above 3.
Primary negative symptoms were considered present if the score on the corresponding negative symptom item was above 3; the score on any positive symptoms item was below 3; the patient had no extrapyramidal symptoms; scores on anxiety and depression items were 3 or below; dose of haloperidol, when applicable, was 15 mg/day or below; and the patient was not taking antiparkinsonian treatment.
The study findings showed that 57.6% of patients had at least one negative symptom, while 12.9% of patients had primary negative symptoms.
The most frequent negative symptoms were social withdrawal (45.8%), emotional withdrawal (39.1%), poor rapport (35.8%), and blunted affect (33.1%).
Furthermore, these symptoms were significantly associated with unemployment, higher Clinical Global Impressions (CGI) scale and PANSS total scores, lower scores on the PANSS positive symptoms subscale, more than 52 weeks of treatment, and high antipsychotic dose.
“Increasing our understanding of the variables associated with negative symptoms in this vulnerable population may help to establish preventing and therapeutic programs for higher risk groups,” say Bobes and team in the Journal of Clinical Psychiatry.
“Improving our methods for measuring these devastating symptoms, coupled with the ongoing development of novel antipsychotic agents, may fuel renewed interest in the evaluation of negative symptoms and optimism that better treatments for negative symptoms can be found."
Source: J Clin Psychiatry / Document Archive
