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

Bobes, Julio; Arango, Celso; García-García, Margarida; Rejas, Javier

doi:10.4088/jcp.08m04250yel

Cited by 231 publications

(162 citation statements)

References 30 publications

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“…We studied the EuroSC cohort, a representative sample of schizophrenia patients from three European countries, which has been extensively used in prior research on this debilitating disease [15–25] Within this cohort, up to a third of patients were in HS2 or HS4 and experienced predominantly negative symptoms that were classed as moderate or severe, in line with earlier studies suggesting that negative symptoms of schizophrenia are indeed very common. In previous reports, 41% of patients experienced two or more negative symptoms [41], while as many as 58% had at least one negative symptom [42]. The impact of negative symptoms on overall functional impairment is substantial and no specific treatment can be considered particularly effective against these symptoms, according to the evidence base summarised in a recent review [43].…”

Section: Discussionmentioning

confidence: 99%

“…In terms of hospitalisations, which are likely to be the most expensive of the healthcare resources investigated, the average needs in patients with severe negative symptoms (HS4) were lower only than in those with extremely severe symptoms (HS8). These results suggest that effective targeting of negative symptoms is likely not only to improve quality of life and social interaction in patients with schizophrenia, as described above, but it may also substantially lower the burden schizophrenia poses on healthcare systems, especially given that negative symptoms are rather common [41,42]. …”

Section: Discussionmentioning

confidence: 99%

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Healthcare resource use in schizophrenia, EuroSC findings

Millier

Horváth

Kóczián

et al. 2017

Journal of Market Access & Health Policy

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Background: It is unclear if the burden associated with schizophrenia is affected by the type and severity of patient’s symptoms. Objective: This study aims to quantify healthcare resource use associated with different profiles of schizophrenia symptoms. Study design: Post-hoc analysis of data from a naturalistic follow-up study. Setting: Secondary psychiatric services in France, Germany and the UK. Patients: EuroSC cohort:, representative sample of 1,208 schizophrenia patients Main outcome measure: We classified patients into eight health states, according to the Lenert classification (HS1–HS8), and estimated 6-month healthcare resource use (outpatient and day clinic visits, and hospitalisations) across the health states. Results: Approximately half of the patients were classed as having mild symptoms (HS1), with around 20% experiencing moderate, predominantly negative symptoms (HS2). The remaining health states were represented by <10% of patients each. Very few patients experienced extremely severe symptoms (HS8). No health state was associated with excess utilisation across all resource types. In terms of outpatient visits, patients were estimated to see a psychiatrist most often (3.01–4.15 visits over 6 months). Hospital admission was needed in 11%(HS1) – 35%(HS8) of patients and inpatient stays were generally prolonged for all health states (39–57 days). The average number of inpatient days was highest for patients in HS8 (18.17 days), followed by patients with severe negative symptoms (HS4; 13.37 days). In other health states characterised by severe symptoms (HS5–HS7), the average number of inpatient days was approximately half of those seen for HS4 (6.09–7.66). Conclusion: While none of the symptom profiles was associated with excess resource usage, hospitalization days were highest for HS with severe, predominantly negative or extremely severe symptoms. Patients with predominantly negative, moderate or severe symptoms appeared to have a high number of psychologist visits – an interesting finding that may reflect a specific therapeutic approach to the treatment of these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Healthcare resource use in schizophrenia, EuroSC findings

Millier

Horváth

Kóczián

et al. 2017

Journal of Market Access & Health Policy

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“…Another study reported the presence of persistent negative symptoms in about 27% of FEP patients with both affective and nonaffective psychosis [28]. Similarly, , reported that in a total of 1452 patients (60.6% male), one or more negative symptom was present in 57.6% of patients, with primary negative symptoms in 12.9% of subjects [29].…”

Section: Discussionmentioning

confidence: 93%

“…Negative symptoms are common and core features of schizophrenia which are responsible for much of the long-term disability and poor functional outcome [5,6]. These symptoms are seen in 35% to 90% of patients, and are generally resistant to treatment, with the exception of clozapine [7,4]. Second generation antipsychotics have claimed to have some success in treatment of negative symptoms though not without skepticism [8].…”

Section: Introductionmentioning

confidence: 99%

Study of negatives symptoms in first episode schizophrenia

Bambole¹,

Shah²,

Sonavane³

et al. 2013

OJPsych

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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.

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“…Negative symptoms affect over half of people with schizophrenia spectrum psychosis (Bobes et al, 2010) and are predictive of poor functional outcomes (Ho et al, 1998;. Negative symptoms are conceptualised as loss, or 'deficit', symptoms (ICD-10, World Health Organisation, 1992), across two consistently identified subdomains: loss of volition/motivation ('avolition/apathy') and flattening of affect ('diminished expression') (Strauss et al, 2013;Kirkpatrick, 2014).…”

Section: Psychological Models Of Negative Symptoms In Psychosismentioning

confidence: 99%