Persistent negative symptoms in first episode patients with schizophrenia: results from the European First Episode Schizophrenia Trial.
Negative symptoms that do not improve following antipsychotic treatment represent a challenge for development of effective treatments. Few studies have been carried out so far, especially in first-episode schizophrenia patients, to clarify prevalence, correlates and impact of persistent negative symptoms (PNS) on short- and long-term outcome of the disease. All patients from EUFEST study for whom both baseline and 12-month assessments were available were included (N=345). PNS were defined as the presence of at least one negative symptom of moderate or higher severity, not confounded by depression or parkinsonism, at baseline and after 1 year of treatment. Patients with PNS were compared to those with at least one negative symptom of moderate or higher severity at the baseline, not persisting after 1 year, on demographic, clinical, neurocognitive, global functioning and quality of life measures. PNS not confounded by depression or parkinsonism were present in 6.7% of the sample. The symptom that more often persisted was blunted affect. Patients with PNS differed from those without PNS for a longer duration of untreated psychosis (DUP) and a more frequent discontinuation of study treatment; they also had a poorer psychopathological outcome and a worse global functioning after 1 year of treatment. The presence of PNS was associated to poorer improvement of all psychopathological dimensions and worse global functioning after 1 year of treatment. The longer DUP in subjects with PNS suggests that programs aimed at shortening DUP might reduce the prevalence of PNS and improve prognosis of schizophrenia.
Department of Psychiatry, University of Naples SUN, Largo Madonna delle Grazie, 80138 Naples, Italy. silvana.galderisi@gmail.com
Silvana
S
Galderisi
Armida
A
Mucci
Istvan
I
Bitter
Jan
J
Libiger
Paola
P
Bucci
W Wolfgang
WW
Fleischhacker
René S
RS
Kahn
D000293:Adolescent; D000328:Adult; D000077582:Amisulpride; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D003072:Cognition Disorders / Q000523:psychology; D003987:Dibenzothiazepines / Q000627:therapeutic use; D005260:Female; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D000077152:Olanzapine; D010879:Piperazines / Q000627:therapeutic use; D011596:Psychomotor Disorders / Q000523:psychology; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000523:psychology; D000069348:Quetiapine Fumarate; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D013469:Sulpiride / Q000031:analogs & derivatives / Q000627:therapeutic use; D013844:Thiazoles / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D010879:Piperazines; D013844:Thiazoles; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; C092292:ziprasidone; D013469:Sulpiride; D000077582:Amisulpride; D006220:Haloperidol; D000077152:Olanzapine