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Schizophrenia is a chronic psychotic disorder comprising positive symptoms, negative symptoms, and cognitive deficits. Negative symptoms are associated with stigma, worse functional outcomes, and a significant deterioration in quality of life. Clinical diagnosis is challenging despite its significance, and current treatments offer little improvement in the burden of negative symptoms. This article reviews current pharmacological strategies for treating negative symptoms. Dopaminergic, glutamatergic, serotonergic, noradrenergic, cholinergic, anti-inflammatory compounds, hormones, and psychostimulants are explored. Finally, we review pharmacological global treatment guidelines for negative symptoms. In general, switching to a second-generation antipsychotic seems to be most often recommended for patients with schizophrenia on first-generation antipsychotics, and an add-on antidepressant is considered when depression is also present. However, the treatment of negative symptoms remains an unmet need. Future, larger clinical studies and meta-analyses are needed to establish effective pharmacological agents for the effective treatment of negative symptoms.
Schizophrenia is a chronic psychotic disorder comprising positive symptoms, negative symptoms, and cognitive deficits. Negative symptoms are associated with stigma, worse functional outcomes, and a significant deterioration in quality of life. Clinical diagnosis is challenging despite its significance, and current treatments offer little improvement in the burden of negative symptoms. This article reviews current pharmacological strategies for treating negative symptoms. Dopaminergic, glutamatergic, serotonergic, noradrenergic, cholinergic, anti-inflammatory compounds, hormones, and psychostimulants are explored. Finally, we review pharmacological global treatment guidelines for negative symptoms. In general, switching to a second-generation antipsychotic seems to be most often recommended for patients with schizophrenia on first-generation antipsychotics, and an add-on antidepressant is considered when depression is also present. However, the treatment of negative symptoms remains an unmet need. Future, larger clinical studies and meta-analyses are needed to establish effective pharmacological agents for the effective treatment of negative symptoms.
BACKGROUND The intervention value of a drug-psycho-social-skill model on medication compliance and cognitive ability in patients with chronic schizophrenia was unknown. AIM To explore the intervention value of a drug-psycho-social-skill model on medication compliance and cognitive ability in patients with chronic schizophrenia. METHODS Overall, 98 out-patients and in-patients with chronic schizophrenia treated in our hospital from February 2022 to January 2023 were included and randomly divided into the study (50 patients) and control groups (48 patients). For 3 months, the control group was treated with conventional drugs, and the research group with a comprehensive intervention model of drug-psychology-society-skills. Data were obtained for the mini mental assessment scale (MMSE), Montreal cognitive assessment scale (MoCA), positive and negative symptom scale, insight and treatment attitude scale, cognitive ability scale and social skills [personal and social function scale (PSP)]. The adverse reactions were observed. RESULTS After the intervention, the MMSE and MoCA scores improved in both groups. MoCA scores in the study group (26.58 ± 3.21) were significantly (P < 0.05) higher than those in the control group (24.68 ± 3.02), MMSE scores were not significantly higher. Post-intervention, positive and negative symptom scores improved in both groups, and the positive and negative symptom scores in the study group [(12.01 ± 2.58) and (32.51 ± 2.11)] were significantly (P < 0.05) different than those in the control group [(14.54 ± 2.33) and (33.74 ± 2.55)]. Post-intervention, insight and treatment attitudes questionnaire scores of both groups were improved and compared with the control group (7.97 ± 3.02), the study group (13.56 ± 6.35) had significantly (P < 0.05) higher scores. Post-intervention, the MATRICS consensus cognitive battery score of both groups was improved and compared with the control group (38.44 ± 6.23), the score of the study group was significantly (P < 0.05) increased (43.51 ± 6.01). Post-intervention, the PSP score of the study group (78.38 ± 6.63) was significantly (P < 0.05) higher than that of the control group (74.52 ± 7.01). During the intervention period, the incidence of adverse reactions in the study group was 6.25%, not significantly different from that in the control group (8.33%). During the intervention, both groups experienced adverse reactions, with no significant difference between groups (P > 0.05). CONCLUSION The comprehensive intervention model based on drug-psychology-society-skills has obvious intervention effects on patients with chronic schizophrenia, which improves their cognitive ability and reduces their positive and negative symptoms. Simultaneously, it improves the self-knowledge of patients, improves their attitude toward treatment, effectively promotes the recovery of patients' social functions, and is safe. Therefore, it is worthy of being vigorously promoted and widely used in clinics.
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