CC BY-NC-ND 4.0 · Journal of Health and Allied Sciences NU 2015; 05(02): 104-115
DOI: 10.1055/s-0040-1703902
Review Article

NEGATIVE SYMPTOMS IN SCHIZOPHRENIA: THE PREVAILING CHALLENGES

Nagesh Pai
1   Professor, Graduate School of Medicine, University of Wollongong New South Wales, Australia 2522.
,
Shae-Leigh C Vella
2   Post Graduate, Graduate School of Medicine, University of Wollongong New South Wales, Australia 2522.
› Institutsangaben

Abstract

Although many advances in the understanding and treatment of schizophrenia have been made many challenges still remain. Most notably is the lack of understanding pertaining to the negative symptoms dimension of schizophrenia and the treatment of such symptomology? Primary negative symptoms affect 20-40% of individuals with schizophrenia and are associated with the greatest impacts upon functional impairment and quality of life. A qualitative review of the prevailing challenges related to the nature, assessment and treatment of negative symptoms was conducted. The current literature in each of the aforementioned areas pertaining to primary negative symptoms was reviewed with a focus upon the key challenges and directions for future research. The results of the qualitative review indicate that the construct of negative symptoms requires further delineation and recent work in the area of the assessment of negative symptoms necessitates further development. In regards to the treatment of negative symptoms no definitive directions are espoused due to the extent of the dearth of knowledge in the area as highlighted in the discussion. The area of negative symptoms research requires multi-disciplinary collaborative research to address the major challenges to the understanding, assessment and treatment of negative symptoms in schizophrenia to improve the quality of life and functional outcomes of those with primary negative symptoms.



Publikationsverlauf

Artikel online veröffentlicht:
22. April 2020

© .

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 
  • References

  • 1 Alphs, L. (2006). An industry perspective on the NIMH consensus statement on negative symptoms. Schizophrenia Bulletin, 33,594-595.
  • 2 American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: DaseSM-IV-TR; The American Psychiatric Association: Washington DC.
  • 3 Andreasen, N. C. (1982). Negative symptoms in schizophrenia: definition and reliability. Archives of General Psychiatry; 39:784-788.
  • 4 Andreasen, N. C. (1983). The Scale for the Assessment of Negative Symptoms (SANS). Iowa City, Iowa: The University of Iowa.
  • 5 Arango C. Carpenter WT. (2011). The schizophrenia construct: symptomatic presentation, in Schizophrenia 3rd ED (eds Weinberger DR, Harrison PJ). Wiley-Blackwell: Oxford, UK.
  • 6 Barch, D. M. (2013). The CAINS: Theoretical and practical advances in the assessment of negative symptoms in schizophrenia. American Journal of Psychiatry; 170(2):133-135.
  • 7 Bell, M. D., Corbera, S., Johannesen, J. K., Fiszdon, J. M. & Wexler, B. E. (2013). Social cognitive impairments and negative symptoms in schizophrenia: Are there subtypes with distinct functional correlates? Schizophrenia Bulletin; 39(1):186-196.
  • 8 Blanchard, J. J., & Cohen, A. S. (2006). The structure of negative symptoms within schizophrenia: Implications for assessment. Schizophrenia Bulletin, 32(2),238-245.
  • 9 Bleuler, E. (1978). Dementia praecox or the group of schizophrenias. International University Press: New York.
  • 10 Bowie, C. R., Reichenberg, A., Patterson, T. L., Heaton, R. K., & Harvey, P. D. (2006). Determinants of real-world functional performance in schizophrenia subjects: Correlations with cognition, functional capacity, and symptoms. American Journal of Psychiatry, 163,418-425.
  • 11 Buchanan, R. W., Javitt, D. C., Marder, S. R., Schooler, N. R., Gold, J. M., McMahon, R. P., Heresco-Levy, U. & Carpenter, W. T. (2007). The Cognitive and Negative Symptoms in Schizophrenia Trial (CONSIST): The efficacy of glutamatergic agents for negative symptoms and cognitive impairments American Journal of Psychiatry, 164,1592-1602.
  • 12 Buckley, P. F. & Stahl, S. M. (2007). Pharmacological treatment of negative symptoms of schizophrenia: therapeutic opportunity or Culde- sac? Acta Psychiatrica Scandinavica; 115:93-100.
  • 13 Carpenter, W. T. (2006). The schizophrenia paradigm: A hundred-year challenge. The Journal of Nervous and Mental Disease; 194(9): 639- 643.
  • 14 Carpenter WT. (2007). Schizophrenia: Disease, Syndrome, or Dimensions? Family Process; 46(2): 199 – 206.
  • 15 DeRosse, P., Lencz, T., Burdick, K. E., Siris, S. G., Kane, J. M. & Malhotra, A. K. (2008). The genetics of symptom-based phenotypes: Toward a molecular classification of schizophrenia. Schizophrenia Bulletin; 34(6):1047-1053.
  • 16 Dlabac-de Lange, J. J., Knegtering, R. & Aleman, A. (2010). Repetitive transcranial magnetic stimulation for negative symptoms of schizophrenia: review and meta-analysis. The Journal of Clinical Psychiatry; 71(4):411-418.
  • 17 Drake, R. E., Bond, G. R., & Essock, S. M. (2009). Implementing evidence-based practices for people with schizophrenia. Schizophrenia Bulletin, 35(4),704-713.
  • 18 Drake, R. E., & Essock, S. M. (2009). The science-to-service gap in realworld schizophrenia treatment: The 95% problem. Schizophrenia Bulletin, 35(4),677-678.
  • 19 Erhart, S. M., Marder, S. R., & Carpenter, W. T. (2006). Treatment of negative symptoms: Future prospects. Schizophrenia Bulletin; 32(2):234-237.
  • 20 Fanous, A. H., Amdur, R. L., O'Neill, F. A., Walsh, D., & Kendler, K. S. (2012). Concordance between chart review and structured interview assessments of schizophrenic symptoms. Comprehensive Psychiatry; 275-279.
  • 21 Flaum, M. & Andreasen, A. (1995). The reliability of distinguishing primary versus secondary negative symptoms. Comprehensive Psychiatry; 36(6):421-427.
  • 22 Forbes, C., Blanchard, J. J., Bennett, M., Horan, W. P., Kring, A. & Gur, R. (2010). Initial development and preliminary validation of a new negative symptom measure: The Clinical Assessment Interview for Negative Symptoms (CAINS). Schizophrenia Research; 124:36-42.
  • 23 Horan, W. P., Kring, A. M., Gur, R. E., Reise, S. P. & Blanchard, J. J. (2011). Development and psychometric validation of the Clinical Assessment Interview for Negative Symptoms (CAINS). Schizophrenia Research; 132:140-145.
  • 24 Javitt, D. C., Spencer, K. M., Thaker, G. K., Winterer, G. & Hajos, M. (2008). Neurophysiological biomarkers for drug development in schizophrenia. Nature Reviews Drug Discovery; 7:68-83.
  • 25 Kaiser, S., Heekeran, K. & Simon, J. J. (2011).The negative symptoms of schizophrenia: category or continuum? Psychopathology; 44: 345- 353.
  • 26 Karlsgodt, K. H., Sun, D. & Cannon, T. D. (2010). Structural and functional brain abnormalities in schizophrenia. Current Directions in Psychological Science; 19(4):226-231.
  • 27 Kay, S. R., Fiszbein, A. & Opler, L. A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin; 13:261-271.
  • 28 Kelley, M. E., Haas, G. L., & van Kammen, D. P. (2008). Longitudinal progression of negative symptoms in schizophrenia: A new look at an old problem. Schizophrenia Research, 105,188-196.
  • 29 Kirkpatrick, B. (2006). Editor's Introduction: Theme issue on negative symptoms. Schizophrenia Bulletin; 32(2):212-213.
  • 30 Kirkpatrick, B., Fenton, W. S., Carpenter, W. T. & Marder, S. R. (2006). The NIMH-MATRICS consensus statement on negative symptoms. Schizophrenia Bulletin; 32(2):214-219.
  • 31 Kirkpatrick, B. & Fisher, B. (2006). Subdomains within the negative symptoms of schizophrenia: Commentary. Schizophrenia Bulletin; 32(2):246-249.
  • 32 Kirkpatrick, B., Strauss G. P., Nguyen, L., Fischer, B. A., Daniel, D. G., Cienfuegos, A. & Marder, S. R. (2011). The Brief Negative Symptom Scale: Psychometric properties. Schizophrenia Bulletin; 37(2): 300- 305.
  • 33 Klingberg, S., Wolwer, W., Engel, C., Wittorf, A., Herrlich, J., Meisner, C., Buchkremer, G. & Wiedemann, G. (2011). Negative symptoms of schizophrenia as primary target of cognitive behavioural therapy: Results of the randomized clinical TONES study. Schizophrenia Bulletin; 37(2): s98-s110.
  • 34 Kraepelin, E. (2009). Lectures on clinical psychiatry. Cornell University Library: Cornell.
  • 35 Kreyenbuhl, J., Buchanan, R. W., Dickerson, F. B. & Dixon, L. B. (2010). The Schizophrenia Patient Outcomes Research Team (PORT): Updated Treatment Recommendations 2009. Schizophrenia Bulletin; 36(1): 94- 103.
  • 36 Lancon, C., Aghababian, V., Llorca, P. M. & Auquier, P. (1998). Factorial structure of the Positive and Negative Syndrome Scale (PANSS): a forced five-dimensional factor analysis. Acta Psychiatrica Scandinavica; 97:396-376.
  • 37 Lehman, A. F., Lieberman, J. A., Dixon, L. B., McGlashan, T. H., Miller, A. L., Perkins, D. O., Kreyenbuhl, J. & American Psychiatric Association Steering Committee on Practice Guidelines. (2004). Practice guideline for the treatment of patients with schizophrenia, second edition. American Journal of Psychiatry, 161,1-56.
  • 38 Leucht, S., Kane, J. M., Kissling, W., Hamann, J., Etschel, E. & Engel, R.R. (2005). What does the PANSS mean? Schizophrenia Research; 79: 231- 238.
  • 39 Lindenmayer, J. P., Grochowski, S. & Hyman, R. B. (1995). Five factor model of schizophrenia: replication across samples. Schizophrenia Research; 14:229-234.
  • 40 Linscott R. J., van Os J. (2010). Systematic reviews of categorical versus continuum models in psychosis: Evidence for discontinuous subpopulations underlying a psychometric continuum. Implications for the DSM-V, DSM-VI and DSM-VII. Annual Review of Clinical Psychology; 6:391-419.
  • 41 Makinen, J., Miettunen J., Isohanni M. & Koponen, H. (2008). Negative symptoms in schizophrenia - a review. Nordic Journal of Psychiatry; 62(5):334-341.
  • 42 Messinger, J. W., Tremeau, F., Antonius, D., Mendelsohn E., Prudent, V., Stanford, A. D., & Malaspina, D. (2011). Avolition and expressive deficits capture negative symtom phenomenology: Implications for DSM-5 and schizophrenia research. Clinical Psychology Review; 31:161-168.
  • 43 Milev, P., Ho, B.-C., Arndt, S., & Andreasen, N. C. (2005). Predictive value of neurocognition and negative symptoms on functional outcome in schizophrenia: A longitudinal first-episode study with 7- year follow-up. American Journal of Psychiatry, 162,495-506.
  • 44 Mojtabai, R., Fochtmann, L., S-W., C., Kotov, R., Craig, T. J., & Bromet, E. (2009). Unmet need for mental health care in schizophrenia: An overview of literature and new data from a first-admission study. Schizophrenia Bulletin, 35(4),679-695.
  • 45 Mojtabai, R., Nicholson, R. A., & Carpenter, B. N. (1998). Role of psychosocial treatments in management of schizophrenia: a metaanalytic review of controlled outcome studies. Schizophrenia Bulletin, 24,569-587.
  • 46 Murphy, B. P., Chung, Y.-C., Park, T.-W., & McGorry, P. D. (2006). Pharmacological treatment of primary negative symptoms in schizophrenia: A systematic review. Schizophrenia Research; 88,5-25.
  • 47 Noroozian, M., Ghasemi, S., Hosseini, S., Modabbernia, A., Khodaie- Ardakani, M., Mirshafiee, O., Farokhnia, M., Tajdini, M., Rezaei, F., Salehi, B., Ashrafi, M., Yekehtaz, H., Tabrizi, M. & Akhondzadeh, S. (2013). A placebo-controlled study of tropisetron added to risperidone for the treatment of negative symptoms in chronic and stable schizophrenia. Psychopharmacology; DOI 10.1007/s00213- 013-3064-2
  • 48 Park, S. G., Llerena, K., McCarthy, J. M., Couture, S. M., Bennett, M. E. & Blanchard, J. J. (2012). Screening for negative symptoms: Preliminary results from the self-report version of the Clinical Assessment Interview for Negative Symptoms. Schizophrenia Research; 135: 139- 143.
  • 49 Parnas, J. (2011). A disappearing heritage: The clinical core of schizophrenia. Schizophrenia Bulletin; 37(6):1121-1130.
  • 50 Patil, S. T., Zhang, L., Martenyi, F., Lowe, S. L., Jackson, K. A., Andreev, B. V., Avedisova, A. S., Bardenstein, L. M., Gurovich, I. Y., Morozova, M. A., Mosolov, S. N., Neznanov, N. G., Reznik, A. M., Smulevich, A. B., Tochilov, V. A., Johnson, B. G., Monn, J. A. & Schoepp, D. D. (2007). Activation of mGlu2/3 receptors as a new approach to treat schizophrenia: a randomized Phase 2 clinical trial. Nature Medicine; 13(9):1102-1107.
  • 51 Peralta, V. & Cuesta, M. J. (2001). How many and which are the psychopathological dimensions in schizophrenia? Issues influencing their ascertainment. Schizophrenia Research; 49:269-285.
  • 52 Pfammater, M., Junghan, U. M., & Brenner, H. D. (2006). Efficacy of psychological therapy in schizophrenia: Conclusions from metaanalyses. Schizophr Bulletin, 32(S1), S64-S80.
  • 53 Pogue-Geile, M. F. & Yokley, J. L. (2010). Current research on the genetic contributors to schizophrenia. Current Directions in Psychological Science; 19:214-219.
  • 54 Rabinowitz, J., Levine, S. Z., Garibaldi, G., Bugarski-Kirola, D., Berardo, C. G. & Kapur, S. (2012). Negative symptoms have greater impact on functioning than positive symptoms in schizophrenia: Analysis of the CATIE data. Schizophrenia Research; 137(1-3):147-150.
  • 55 Rector, N. A., Beck, A. T., Stolar, N. (2005). The negative symptoms of schizophrenia: a cognitive perspective. Canadian Journal of Psychiatry; 50(5):247-257.
  • 56 Singh, S. P., Singh, V. Kar, N. & Chan, K. (2010). Efficacy of antidepressants in treating the negative symptoms of chronic schizophrenia: meta-analysis. The British Journal of Psychiatry; 197:174-179.
  • 57 Stahl, S. M., & Buckley, P. F. (2007). Negative symptoms in schizophrenia: a problem that will not go away. Acta Psychiatrica Scandinavica, 115,4-11.
  • 58 Staring, A. B. P., ter Huurne, M. B. & van der Gaag, M. (2013). Cognitive behavioral therapy for neagtive symptoms (CBT-n) in psychotic disorders: A pilot study. Journal of Behaviour Therapy and Experimental Psychiatry; 44:300-306.
  • 59 Strauss, G. P., Hong, L. E., Gold, J. M., Buchanan, R. W., McMahon, R. P., Keller, W. R., Fischer, B. A., Catalano, L. T., Cullbreth, A. J., Carpenter, W. T. & Kirkpatrick, B. (2012). Factor structure of the brief negative symptom scale. Schizophrenia Bulletin; In Press.
  • 60 Strauss, G. P., Horan, W. P., Kirkpatrick, B. A., Keller, W. R., Miski, P., Buchanan, R. W., Green, M. F. & Carpenter Jr, W. T. (2013). Deconstructing negative symptoms of schizophrenia: Avolition - apathy and diminished expression clusters predict clinical presentation and functional outcome. Journal of Psychiatric Research; 47:783-790.
  • 61 Strauss, G. P., Wilbur, R. C., Warren, K. R., August, S. M. & Gold, J. M. (2011). Anticipatory vs. consummatory pleasure: What is the nature of hedonic deficits in schizophrenia? Psychiatry Research; 187:36-41.
  • 62 Tandon, R., Nasrallah, H.A. & Keshavan, M. S. (2010). Schizophrenia, "Just the Facts" 5. Treatment and prevention past, present and future. Schizophrenia Research; 122:1-23.
  • 63 Tarrier, N., & Wykes, T. (2004). Is there evidence that cognitive behaviour therapy is an effective treatment for schizophrenia? A cautious or cautionary tale? Behaviour Research and Therapy, 42,1377-1401.
  • 64 Thorup, A., Petersen, L., Jeppesen, P., Ohlenschlaeger, J., Christensen, T., Kararup, G., Jorgensen, P., & Nordentoft, M. (2005). Integrated treatment ameliorates negative symptoms in first episode psychosis-results from the Danish OPUS trial. Schizophrenia Research, 79,95-105.
  • 65 Toomey, R., Keremen, W., Simpson, J. C., Samson, J. A., Seidman, L. J., Lyons, M. J., Faraone, S. V. & Tsuang, M. T. (1997). Revisiting the factor structure for positive and negative symptoms: Evidence from a large heterogeneous group of psychiatric patients. American Journal of Psychiatry, 154,371-377.
  • 67 Turkington, D. & Morrison, A. P. (2012). Cognitive therapy for negative symptoms of schizophrenia. Archives of General Psychiatry; 69(2):119-120.
  • 68 Velligan, D. I., Mueller, J., Wang, M., Dicocco, M., Diamond, P. M., Maples, N. J. & Davis, B. (2006). Use of environmental supports among patients with schizophrenia. Psychiatric Services: 59:219-224.
  • 69 Whittington, C., Barnes, T. R. E. & Kendall, T. (2010). Antipsychotics for people with persistent negative symptoms of schizophrenia. Cochrane Database of Systematic Reviews; 3: Art. No.: DOI: 10.1002/14651858.CD008406 115