Impact of primary negative symptoms on functional outcomes in schizophrenia

• Published in: European psychiatry Vol. 29; no. 7; pp. 449 - 455
• Main Authors: Fervaha, G, Foussias, G, Agid, O, Remington, G
• Format: Journal Article
• Language: English
• Published: Paris Elsevier Masson SAS 01.09.2014; Elsevier
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Aged; Antipsychotic Agents - therapeutic use; Apathy; Avolition-Apathy; Biological and medical sciences; Female; Functional outcome; Humans; Internal Medicine; Male; Medical sciences; Middle Aged; Negative symptoms; Primary symptoms; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Psychosocial functioning; Schizophrenia; Schizophrenia - drug therapy; Schizophrenic Psychology; Treatment Outcome; Young Adult; Schizophrenia; Primary symptoms; Negative symptoms; Psychosocial functioning; Avolition-Apathy; Functional outcome; Psychosis; Apathy; Symptomatology; Social behavior; Social interaction; Negative symptom
• ISSN: 0924-9338; 1778-3585
• DOI: 10.1016/j.eurpsy.2014.01.007

Abstract Objective Negative symptoms are known to undermine functional outcomes in people with schizophrenia; however, most studies have not accounted for whether these symptoms were primary or secondary to other psychopathological factors. The present study examined the impact of primary negative symptoms on functional outcomes in patients with schizophrenia. Method The sample included 1427 patients with schizophrenia who completed the baseline visit in the CATIE study. Symptoms were assessed with the Positive and Negative Syndrome Scale and Calgary Depression Scale, extrapyramidal side effects with the Simpson-Angus scale, and functional status with the Heinrichs-Carpenter Quality of Life Scale. Results Negative symptoms were significantly and inversely related to each domain of functioning examined. These relationships remained after statistically controlling for the influence of potential sources of secondary negative symptoms. In addition, the relationships between negative symptoms and specific domains of functioning remained in patients who had mild/absent positive, depressive, anxiety and extrapyramidal symptoms. Negative symptoms were associated with functional outcomes even in antipsychotic-free patients. Conclusions Primary negative symptoms significantly contribute to the functional impairment seen in people with schizophrenia. A better understanding of the etiology and pathobiology of these symptoms is required to guide the search for effective therapeutics that promote functional recovery.