Depression, affect and negative symptoms in schizophrenia

Article Abstract:

In order to evaluate relationships between depression, impaired mood and emotionality (affect), and the positive and negative symptoms of schizophrenia, 37 newly admitted, young urban patients of mixed ethnic backgrounds (with an average age of 24 years) and an illness onset of two years or less were studied and followed-up for two years. During the first two weeks of their first schizophrenic admission, they were given a battery of tests to assess affect, attention span, drug-induced neurological symptoms, and positive and negative syndrome factors. A positive symptom score was obtained by summing ratings of delusions, thought disorder, paranoia, hallucinations, excitability, grandiosity, and hostility. A negative score added ratings for blunted affect, emotional withdrawal, passivity, poor abstract thinking, and poverty of speech. Factor analysis of the initial tests revealed three distinct affective clusters: (1) emotional unrelatedness; (2) immobility of facial and gestural expression; and (3) inappropriate affect. The first two factors were significantly related to each other and to depression. Depression was also significantly related to concurrent negative symptoms. The third factor was only significantly related to high positive scores. A two-year follow-up evaluation revealed that an initial high depression rating was significantly related to better overall level of functioning, social relations and occupational adjustment. Poor premorbid functioning (that is, before onset of the illness) was found to be highly related to (1). At the onset of the study, depression was significantly higher among nonparanoid patients. After two years, paranoia was only significantly related to an initial high rating on factor (3). Results suggest that the affective profiles of young, acute schizophrenics include three distinct dimensions with concurrent and predictive significance. (Consumer Summary produced by Reliance Medical Information, Inc.)

Depression, Mental, Depression (Mood disorder)

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The prediction of rehabilitative success after three years: the use of social, symptom and cognitive variables

Article Abstract:

Twenty-eight schizophrenic patients and 21 other long-term psychiatric patients were evaluated to assess rehabilitative success of outpatient treatment. Success of treatment was indicated by: (1) total number of symptoms; (2) amount of positive, or florid, symptoms such as hallucinations and delusions compared with negative, or deficit, symptoms such as social withdrawal, flattened emotions or poverty of speech; (3) social behavior problems; (4) illness chronicity; (5) job skills and employment; and (6) living circumstances. Four levels of difficulty in information processing (how people organize, memorize and use information to solve problems) were also assessed by measuring task response time (RT). Rehabilitative services were divided into day and night care, and further categorized according to relatively independent (e.g., living at home) versus dependent (e.g., inpatient psychiatric care) types of treatment. Analysis of the data demonstrated that patients with slow RTs were less likely to improve. Although the RT measurement only reached statistical significance for the night-care patients, both day and night-care patients with slow RTs tended to move from independent to more dependent types of care. Schizophrenic patients had significantly slower response-processing RTs than other patients. Moving to more independent types of rehabilitative care over the three-year follow-up period was found to be significantly associated with low numbers of negative symptoms, a diagnosis other than schizophrenia, low ratings of social behavior problems, and a relatively high peak level of job and living skills. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Mentally ill persons, Mentally ill, Mental illness, Mental disorders

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The prognostic significance of negative symptoms in schizophrenia

Article Abstract:

A review of research on the negative symptoms of schizophrenia reveals confusing variations in experimental methodology and diagnostic criteria, as well as inconsistent results. Negative symptoms are usually defined by blunted mood and emotions (affect), poverty of speech and slow movement. Studies of the prognostic or predictive value of negative symptoms assessed during an acute schizophrenic episode have been inconclusive. However, studies that have looked at symptoms occurring during nonacute or posthospitalization periods have found negative symptoms to be strong predictors of poor overall functioning at two- and five-year follow-up evaluations. This may be because negative symptoms during postacute episodes are less likely to be secondary symptoms related to neuroleptic (antipsychotic) medication side-effects, or responses to psychosis. Studies examining social withdrawal and functioning deficits prior to first schizophrenic hospital admission suggest a moderate ability to predict the eventual development of negative symptoms. The overall prognostic utility of negative symptoms in evaluating illness outcome is much more moderate than previously thought. Studies also suggest that more changes occur in negative symptoms over time than previously expected. We still do not know whether or not negative symptoms stabilize or become more predominant during the later course of illness, but the degree of symptom instability demonstrated by recent studies argues against a model relating all negative symptoms to brain abnormalities. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cognition, Emotions, Emotions and cognition

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