Negative Symptoms of Schizophrenia
Authors:
R. Přikryl; H. Kučerová
Authors‘ workplace:
Psychiatrická klinika LF MU a FN, Brno
přednostka prof. MUDr. E. Češková, CSc.
Published in:
Čes. a slov. Psychiat., 104, 2008, No. 7, pp. 350-357.
Category:
Comprehensive Reports
Overview
Together with cognitive deficit, negative symptoms are regarded as forming the core part of schizophrenia. The neurobiological mechanisms underlying positive and negative symptoms of schizophrenia seem to differ. While the etiopathogenesis of negative symptoms is described in terms of impairment of specific brain areas, the causes for positive symptoms are being associated with an imbalance of neurotransmitters in the brain. Unlike positive symptoms, negative symptoms affect the social and work involvement of patients including their overall quality of life to a much greater extent. Flattened emotions, impaired speech, anhedonia, lack of will or psychomotor slowdown continue to impair the patients’ skills even after the positive symptoms have been removed. The greater severity of negative symptoms in the initial stages contributes to the severity of the illness, too. Although the extent to which negative symptoms can be alleviated using the second generation antipsychotics is greater than it was for the first generation antipsychotics, it is regarded as clinically unsatisfactory. The insufficient effect of therapy on negative symptoms is currently regarded as one of the greatest issues in treatment of schizophrenia.
Key words:
cognitive deficit, negative symptoms, schizophrenia.
Sources
1. Alphs, L.: An industry perspektive on the NIMH consensus statement on negative symptoms. Schizophrenia Bulletin, 32, 2006, pp. 225-230.
2. Anderson, J. E., Wible, C. G., McCarley, R. W., Jakab, M., Kasai, K., Shenton, M. E. An MRI study of tempoval lobe abnormalities and negative symptoms in chronic schizophrenia. Schizophr. Res., 58, 2002, pp. 123-134.
3. Andreasen, N. C., Kezai, K., Alliger, R., Swayze, V. W., Flaum, M., Kirchner, P., Cohen, G., OĹeary, D. S.: Hypofrontality in neuroleptic-naive patients and in patients with chronic schizophrenia. Assessment with xenon 133 single-photon emission computed tomography and the Tower of London. Arch. Gen. Psychiatry, 49, 1992, pp. 943-958.
4. Andreasen, N. C., Kezai, K., Alliger, R. et al. Hypofrontality in neuroleptic naive patients and in patients with chronic schizophrenia. Archives of General Psychiatry, 26, 1992, pp. 14-16.
5. Andreasen, N. C.: The evolving concept of schizophrenia: from Kraepelin to the present and future. Schizophr. Res., 28, 1997, pp. 105-109.
6. Berman, J., Viegenen, B., Vielson, A., Alian, E., Pallas, J., Green, A. L.: Differential relationship between positive and negative symptoms and neuropsychological deficits in schizophrenia. Schizophr. Res., 25, 1997, pp. 1-10.
7. Bow-Thomas, C. C., Velligan, D. I., Miller, A. L., Olsen, J.: Predicting quality of life from symptomatology in schizophrenia at exacerbation and stabilization. Psychiatry Res., 86, 1999, pp. 131-142.
8. Bowie, C. R., Reichenberg, A., Patterson, T. L. et al.: Determinants of real-world functional performance in schizophrenia subjects: correlations with cognition, functional capacity, and symptoms. Am. J. Psychiatry, 163, 2006, pp. 418-425.
9. Buckley, P. F.: Neuroimaging of schizophrenia: structural abnormalities and pathophysiological implication. Neuropsychiatr. Dis. Treat., 1, 2005, pp. 193-204.
10. Buchanan, R. W., Brandes, M., Breier, A.: Treating negative symptoms: pharmacological strategies. In: Breier, A., (ed.): The New Pharmacology of Schizophrenia. Washington, D.C. American Psychiatric Press, 1996, pp. 179-204.
11. Buchanan, R. W., Breier, A., Kirkpatrick, B., Ball, P. et al.: Positive and negative symptom response to clozapine in schizophrenic patients with and without the deficit syndrom. Am. J. Psychiatry, 155, 1998, pp. 751-760.
12. Buchsbaum, M. S., Invar, D. H., Kessler, R.: Cerebral glucography with positron tomography. Use in normal subjects and in patients with schizophrenia. Arch. Gen. Psychiatry, 39, 1982, pp. 251-259.
13. Callicott, J. H., Bertolino, A., Egan, M. F. et al.: Selective relationship between prefrontal N-acetylaspartate measures and negative symptoms in schizophrenia. Am. J. Psychiatry, 157, 2000, pp. 1646-1651.
14. Carpenter, W. T., Heinrichs, D. W., Wagman, A. M. I.: Deficit and nondeficit forms of schizophrenia: the concept. Am. J. Psychiatry, 145, 1988, pp. 578-583.
15. Carpenter, W. T., Kirkpatrick, B.: The heterogenity of the long-term course of schizophrenia. Schizophr. Bulletin, 14, 1988, pp. 645-659.
16. Chen, R. Y., Chen, R., Ho, W. Y: A five-year longitudional study of the regional cerebral metabolic changes of a schizophrenic patient from the first episode using Tc-99m HMPAO SPECT. European Archives of Psychiatry and Clinical Neuroscience, 250, 2000, pp. 69-72.
17. Crow, T. J.: Molecular pathology of schizophrenia: more than one disease process? British Medical Journal, 280, 1980, pp. 66-68.
18. Crow, T. J.: Brain changes and negative symptoms in schizophrenia. Psychopathology, 28, 1995, pp. 18-21.
19. Davis, J., Chen, N.: Clinical profile of an atypical antipsychotic: Risperidone. Schizophr Bulletin, 28, 2002, pp. 43-61.
20. Delamillieure, P., Fernandez, J., Constans, J. M. et al.: Proton magnetic resonance spectroscopy of the medial prefrontal cortex in patiens with deficit schizophrenia: preliminary report. Am. J. Psychiatry, 157, 2000, pp. 641-643.
21. Dickerson, F., Boronow, J. J., Ringel, N., Parente, F.: Social functioning and neurocognitive deficits in outpatients with schizophrenia: a 2 year follow-up. Schizophr. Res., 37, 1999, pp. 13-20.
22. Erhart, S. M., Marder, S. R., Carpenter, W. M.: Treatment of schizophrenia negative symptoms: future prospects. Schizophrenia Bulletin, 32, 2006, pp. 234-237.
23. Fenton, W. S., McGlashan, T. H.: Antecedents, symptoms progression, and long-term outcome of the deficit syndrome in schizophrenia. Am. J. Psychiatry, 151, 1994, pp. 351-356.
24. Fleischhacker, W. E.: New drugs for the treatment of schizophrenic pacients. Acta Psychiatr. Scand. Suppl., 388, 1995, pp. 24-30.
25. Frank, P.: Assessment of frontal lobe functioning in schizophrenia and unipolar major depression. Psychopatology, 26, 1993, pp. 76-84.
26. Ginsberg, D. L., Schiller, N. R., Buckley, P. F. et al.: Optimizing treatment of schizophrenia. Enhancing affective/ cognitive and depressive functioning. CNS Spectr, 10, 2005, pp. 1-13.
27. Harvey, P. D., Koren, D., Reichenberg, A., Bowle, C. R.: Negative symptoms and cognitive deficits: What is the nature of their relationship? Schizophr. Bulletin, 32, 2006, pp. 250-258.
28. Heinrichs, R. W., Zaksatis, K. K.: Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology, 12, 1998, pp. 426-445.
29. Heydebrand, G., Weiser, M., Rabinowitz, J., Hoff, A. L., DeLisi, I. E., Csernansky, J. G.: Correlates of cognitive deficits in first episode schizophrenia. Schizoph. Res., 68, 2004, pp. 1-9.
30. Horáček, J., Kopeček, M., Linhartová, L., Bělohlávek, O., Janeba, D., Španiel, F., Hájek, T.: Regionální metabolismus mozku a příznaky schizofrenie studie pozitronové emisní tomografie (PET). Psychiatrie, 1, 2001, s. 1-11.
31. Kay, S. R., Fiszbein, A., Opler, L. A.: The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr. Bull., 13, 1987, pp. 261-276.
32. Kirkpatrick, B., Fenton, W. S., Carpenter, W. T., Marder, S. R.: The NIMH-MATRICS consensus statement on negative symptoms. Schizophr. Bulletin, 32, 2006, pp. 214-219.
33. Kopelowitz, A., Lieberman, R., Mintz, J., Zarate, R.: Comparison of efficacy of social skills training for deficit and nondeficit negative symptoms in schizophrenia. Am. J. Psychiatry, 154, 1997, pp. 424-425.
34. Lauriello, J., Lenroot, R., Hustilko, J.: Maximizing the synergy between pharmacotherapy and psychosocial therapies for schizophrenia. Psychiatr. Clin. North Am., 26, 2006, pp. 191-211.
35. Lecrubier, Y., Quintin, P., Bouhassira, M. et al.: The treatment of negative symptoms and deficit states of chronic schizophrenia: olanzapine compared to amisulpride and placebo in a 6 month double blind controlled clinical trial. Acta Psych. Scandinavica, 114, 2006, pp. 319-327.
36. Leucht, S., Pitschel-Walz, G., Abraham, D., Kissling, W.: Efficacy and extrapyramidal side effects of the new antipsychotics olanzapine, quetiapine, risperidone and sertindole compared to conventional antipsychotics and placebo. A meta-analysis of randomized controlled trials. Schizophr. Res., 35, 1999, pp. 51-68.
37. Liddle, P. F., Friston, K. J., Frith, C. D., Hirsch, S. R., Jones, T., Frackowiak, R. S.: Patterns of cerebral blood flow in schizophrenia. Br. J. Psychiatry, 160, 1992, pp. 179-186.
38. Meltzer, H. Y., Sommers, A. A., Luchins, D. J.: The effect of neuroleptics and other psychotropic drugs on negative symptoms in schizophrenia. J. Clin. Psychopharmacol, 6, 1986, pp. 329-338.
39. Meyer-Linderberg, A., Truple, H., Bauer, U. et al.: Improvement of cognitive function in schizophrenic patients receiving clozapine or zotepine: Results from a double-blind study. Pharmacopsychiatry, 30, 1997, pp. 35-42.
40. Milev, P., Ho, B. C., Arndt, S., Andreasen, N. C.: Predictive values of neurocognition and negative symptoms on functional outcome in schizophrenia: a longitudional first-episode study with 7-year follow-up. Am. J. Psychiatry, 162, 2005, pp. 495-506.
41. Min, S. K., An, S. K., Jon, D. I., Lee, J. D.: Positive and negative symptoms and regional cerebral perfusion in antipsychotics-naive schizophrenic patiens: a high-resolution SPECT study. Psychiatry Res., 90, 1999, pp. 159-168.
42. Möller, H. J.: Management of the negative symptoms of schizophrenia: new treatment options. CNS Drugs, 17, 2003, pp. 793-823.
43. OĹeary, D. S., Keller, M. L. et al.: Cognitive correlates of negative, disorganized, and psychotic symptom dimensions of schizophrenia. J. Neuropsychiatry Clin. Neurosci, 12, 2000, pp. 4-15.
44. Pantelis, C., Yugel, M., Wood, S. J. et al.: Structural brain imaging evidence for multiple pathological processes at different stages of brain development in schizophrenia. Schizophr. Bulletin, 31, 2005, pp. 672-696.
45. Potkin, S. G., Alva, G., Fleming, K. et al.: A PET study of the pathophysiology of negative symptoms in schizophrenia. Positron emission tomography. Am. J. Psychiatry, 159, 2002, pp. 227-237.
46. Rabinowitz, J., DeSmedt, G., Harvey, P. D., Davidson, M.: The relationship between premorbid functioning and symptom severity as assessed at the first episode of psychosis. Am. J. Psychiatry, 159, 2002, pp. 2021-2026.
47. Rehn, A. E., Rees, S. M.: Investigating the neurodevelopmental hypothesis of schizophrenia. Clin. Exp. Pharmacol. Physiol., 32, 20005, pp. 687-696.
48. Sanfilipo, M., Lafargue, T., Rusinek, H. et al.: Volumetric measure of the frontal and tempoval lobe regions in schizophrenia: relationshiop to negative symptoms. Arch. Gen. Psychiatry, 57, 2000, pp. 471-480.
49. Sigmudsson, T., Suckling, J., Maier, M. et al.: Structural abnormalities in frontal, temporal, and limbic regions and interconnecting white matter tracks in schizophrenic patiens with prominent negative symptoms. Am. J. Psychiatry, 158, 2001, pp. 34-43.
50. Stahl, S. M.: Positive findings for negative symptoms of schizophrenia: no longer untreatable? Acta Psych. Scandinavica, 2007, in press.
51. Stahl, M. S., Buckley, P. F.: Negative symptoms of schizophrenia: a problem that will not go away. Acta Psychiatr. Scand., 115, 2007, pp. 4-11.
52. Tamminga, C. A., Thaker, G. K., Buchanan, R., Kirkpatrick, B., Alphs, L. D., Chase, T. N.: Limbic system abnormalities identified in schizophrenia using positron emission tomography with fluorodeofyglucose and neocortical alterations with deficit syndrome. Arch. Gen. Psychiatry, 49, 1992, pp. 522-530.
53. Tollefson, G., Bealey, C., Tran, P., Street, J. et al.: Olanzapine versus Haloperidol in the treatment of schizophrenia and schizoaffective and schizophreniform disorders: results of an international collaborative trial. Am. J. Psychiatry, 154, 1997, pp. 457-474.
54. Weinberger, D. R., Berman, K. F., Zec, R. F. Physiologic dysfunction of dorsolateral prefrontal cortex in schizophrenia. Regional cerebral bloof flow evidence. Arch. Gen. Psychiatry, 43, 1986, pp. 114-124.
55. White, L., Harvey, P. D., Opler, L., Lindenmayer, J. P.: Empirical assessment of the factorial structure of clinical symptoms in schizophrenia: a multisite, multimodel evaluation of the factorial structure of the Positive and Negative Syndrom Scale. Psychopatology, 30, 1997, pp. 263-274.
56. Wible, C. G., Anderson, J., Shenton, M. E. et al.: Prefrontal cortex, negative symptoms, and schizophrenia: an MRI study. Psychiatry Res, 108, 2001, pp. 65-78.
57. Wolkin, A., Choi, S. J., Szilagyi, S., Sanfilipo, M., Rotrosen, J. P., Lim, K. O.: Inferior frontal white matter anisotropy and negative symptoms of schizophrenia: a diffusion tensor imaging study. Am. J. Psychiatry, 160, 2003, pp. 572-574.
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Czech and Slovak Psychiatry
2008 Issue 7
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