Negative symptoms and their association with depressive symptoms in the long-term course of schizophrenia

Heiden, Wolfram an der; Leber, Anne; Häfner, Heinz

doi:10.1007/s00406-016-0697-2

Cited by 68 publications

(45 citation statements)

References 57 publications

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“…The finding of an overall decrease in apathy levels in the long-term is in line with results from two previous follow-up studies from FEP [30] and first-admission schizophrenia participants [51]. In the FEP TIPS study, a group characterized by enduring high apathy levels was discernible in the second year of treatment.…”

Section: Development Of Apathy In Participants With Fepsupporting

confidence: 90%

Trajectory and early predictors of apathy development in first-episode psychosis and healthy controls: a 10-year follow-up study

Lyngstad

Gardsjord

Engen

et al. 2020

Eur Arch Psychiatry Clin Neurosci

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Apathy is prevalent in first-episode psychosis (FEP) and associated with reduced global functioning. Investigations of the trajectory of apathy and its early predictors are needed to develop new treatment interventions. We here measured the levels of apathy over the first 10 years of treatment in FEP and in healthy controls (HC). We recruited 198 HC and 198 FEP participants. We measured apathy with the Apathy Evaluation Scale, self-report version, psychotic symptoms with the Positive and Negative Syndrome Scale, depression with the Calgary Depression Scale for Schizophrenia, functioning with the Global Assessment of Functioning Scale, and also estimated the duration of untreated psychosis (DUP). The longitudinal development of apathy and its predictors were explored using linear mixed models analyses. Associations to functioning at 10 years were investigated using multiple hierarchical linear regression analyses. In HC, mean apathy levels were low and stable. In FEP, apathy levels decreased significantly during the first year of treatment, followed by long-term stability. High individual levels of apathy at baseline were associated with higher apathy levels during the follow-up. Long DUP and high baseline levels of depression predicted higher apathy levels at follow-ups. The effect of DUP was persistent, while the effect of baseline depression decreased over time. At 10 years, apathy was statistically significantly associated with reduced functioning. The early phase of the disorder may be critical to the development of apathy in FEP.

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Section: Development Of Apathy In Participants With Fepsupporting

confidence: 90%

Trajectory and early predictors of apathy development in first-episode psychosis and healthy controls: a 10-year follow-up study

Lyngstad

Gardsjord

Engen

et al. 2020

Eur Arch Psychiatry Clin Neurosci

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“…Individuals at clinical high-risk for schizophrenia from the North American Prodrome Longitudinal Study (NAPLS) cohort have depressive symptoms that have been shown to be associated with negative symptoms (124). This association has also been reported in longitudinal data of patients with schizophrenia extending from the first episode to 10+ years of chronic psychosis (125). Furthermore, a recent meta-analysis reported a relationship between negative symptoms of schizophrenia and defeatist personal beliefs, a cognitive construct thought to underlie motivational deficits in individuals with depression (126).…”

Section: The Role Of Inflammation In Reward Processing Deficits In Psmentioning

confidence: 71%

Inflammation and Negative Symptoms of Schizophrenia: Implications for Reward Processing and Motivational Deficits

Goldsmith

Rapaport

2020

Front. Psychiatry

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Negative symptoms of schizophrenia are debilitating and chronic in nature, are difficult to treat, and contribute to poor functional outcomes. Motivational deficits are a core negative symptom and may involve alterations in reward processing, which involve subcortical regions such as the basal ganglia. More specifically, dopamine-rich regions like the ventral striatum, have been implicated in these reward-processing deficits. Inflammation is one mechanism that may underlie negative symptoms, and specifically motivational deficits, via the effects of inflammatory cytokines on the basal ganglia. Previous work has demonstrated that inflammatory stimuli decrease neural activity in the ventral striatum and decrease connectivity in reward-relevant neural circuitry. The immune system has been shown to be involved in the pathophysiology of schizophrenia, and inflammatory cytokines have been shown to be altered in patients with the disorder. This paper reviews the literature on associations between inflammatory markers and negative symptoms of schizophrenia as well as the role of anti-inflammatory drugs to target negative symptoms. We also review the literature on the role of inflammation and reward processing deficits in both healthy controls and individuals with depression. We use the literature on inflammation and depression as a basis for a model that explores potential mechanisms responsible for inflammation modulating certain aspects of negative symptoms in patients with schizophrenia. This approach may offer novel targets to treat these symptoms of the disorder that are significant barriers to functional recovery and do not respond well to available antipsychotic medications.

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“…10 Negative symptoms commonly appear during the prodromal phase of schizophrenia and before the first acute psychotic episode ( Figure 2). 2,[9][10][11] Among patients with negative symptoms, 73% had them before the onset of positive symptoms and 20% experienced them within the same month as positive symptoms. 11 Prodromal onset of negative symptoms has been characterized as a risk factor for the switch to psychosis 12,13 and it is associated with negative symptoms in the first psychotic episode.…”

Section: Negative Symptom Coursementioning

confidence: 99%

“…2,[9][10][11] Among patients with negative symptoms, 73% had them before the onset of positive symptoms and 20% experienced them within the same month as positive symptoms. 11 Prodromal onset of negative symptoms has been characterized as a risk factor for the switch to psychosis 12,13 and it is associated with negative symptoms in the first psychotic episode. 14 Negative symptoms can also present during the psychotic phase of illness, so clinicians should be mindful of positive symptoms that are accompanied by decreased emotional expression, social withdrawal, and functional deterioration.…”

Section: Negative Symptom Coursementioning

confidence: 99%

<p>Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment</p>

Correll¹,

Schooler²

2020

NDT

512

347

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Schizophrenia is frequently a chronic and disabling disorder, characterized by heterogeneous positive and negative symptom constellations. The objective of this review was to provide information that may be useful for clinicians treating patients with negative symptoms of schizophrenia. Negative symptoms are a core component of schizophrenia that account for a large part of the long-term disability and poor functional outcomes in patients with the disorder. The term negative symptoms describes a lessening or absence of normal behaviors and functions related to motivation and interest, or verbal/emotional expression. The negative symptom domain consists of five key constructs: blunted affect, alogia (reduction in quantity of words spoken), avolition (reduced goal-directed activity due to decreased motivation), asociality, and anhedonia (reduced experience of pleasure). Negative symptoms are common in schizophrenia; up to 60% of patients may have prominent clinically relevant negative symptoms that require treatment. Negative symptoms can occur at any point in the course of illness, although they are reported as the most common first symptom of schizophrenia. Negative symptoms can be primary symptoms, which are intrinsic to the underlying pathophysiology of schizophrenia, or secondary symptoms that are related to psychiatric or medical comorbidities, adverse effects of treatment, or environmental factors. While secondary negative symptoms can improve as a consequence of treatment to improve symptoms in other domains (ie, positive symptoms, depressive symptoms or extrapyramidal symptoms), primary negative symptoms generally do not respond well to currently available antipsychotic treatment with dopamine D 2 antagonists or partial D 2 agonists. Since some patients may lack insight about the presence of negative symptoms, these are generally not the reason that patients seek clinical care, and clinicians should be especially vigilant for their presence. Negative symptoms clearly constitute an unmet medical need in schizophrenia, and new and effective treatments are urgently needed.

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Negative symptoms and their association with depressive symptoms in the long-term course of schizophrenia

Cited by 68 publications

References 57 publications

Trajectory and early predictors of apathy development in first-episode psychosis and healthy controls: a 10-year follow-up study

Trajectory and early predictors of apathy development in first-episode psychosis and healthy controls: a 10-year follow-up study

Inflammation and Negative Symptoms of Schizophrenia: Implications for Reward Processing and Motivational Deficits

<p>Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment</p>

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