title: Association of prominent positive and prominent negative symptoms and functional health, well-being, healthcare-related quality of life and family burden: a CATIE analysis.
abstract: BACKGROUND
  There is an increased interest in evaluating the impact of core symptoms of schizophrenia, both positive and negative, on functioning and burden of disease.
  
  
  OBJECTIVE
  To examine the extent to which prominent positive and prominent negative symptoms impact functional health, well-being, health-related quality of life (HRQoL), and family burden.
  
  
  METHODS
  Data on symptomatology, HRQoL, and resource use from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) were analyzed (n=1447). Patients were divided into four groups based on the Positive and Negative Syndrome Scale (PANSS) using published criteria as having (a) neither prominent positive nor prominent negative symptoms (n=575; 39.7%); (b) only prominent negative symptoms (n=274; 18.9%); (c) only prominent positive symptoms (n=295; 20.4%); or (d) both prominent positive and negative symptoms (n=303; 20.9%). Differences were examined for overall significance between the groups and for a linear trend.
  
  
  RESULTS
  There was a significant linear decline in the outcome measures with each subsequent symptom group, with the combination of prominent positive and negative symptoms incrementing the decline further on quality-adjusted life-years derived from the PANSS, Short-Form-12, Index of Functioning, HRQoL measures, and number of workdays missed by caregiver during the month prior to CATIE (all p<0.001).
  
  
  CONCLUSIONS
  Both prominent positive and prominent negative symptoms of schizophrenia are independently associated with significant decline in functionality, HRQoL, and caregiver lost workdays. An increased burden is observed in patients with highest symptomatology. Further research is needed to determine predictors of poor outcomes and burden of schizophrenia.
authors.affiliation: Bar-Ilan University, Ramat Gan, Israel. Electronic address: jonathan.rabinowitz@biu.ac.il.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Rabinowitz
authors.forename: Carmen Galani
authors.initials: CG
authors.lastname: Berardo
authors.forename: Dragana
authors.initials: D
authors.lastname: Bugarski-Kirola
authors.forename: Stephen
authors.initials: S
authors.lastname: Marder
mesh_terms: D002986:Clinical Trials as Topic; D005190:Family / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012559:Schizophrenia / Q000188:drug therapy* / Q000191:economics*; D012565:Schizophrenic Psychology
keywords: Burden; Functional health; Prominent negative; Prominent positive; Quality of life; Schizophrenia