title: Impact of primary negative symptoms on functional outcomes in schizophrenia.
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.
  
  
  METHODS
  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.
authors.affiliation: Schizophrenia Division, Centre for Addiction and Mental Health, 250, College Street, M5T 1R8 Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada. Electronic address: gagan.fervaha@utoronto.ca.
authors.forename: G
authors.initials: G
authors.lastname: Fervaha
authors.affiliation: Schizophrenia Division, Centre for Addiction and Mental Health, 250, College Street, M5T 1R8 Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Foussias
authors.affiliation: Schizophrenia Division, Centre for Addiction and Mental Health, 250, College Street, M5T 1R8 Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: O
authors.initials: O
authors.lastname: Agid
authors.affiliation: Schizophrenia Division, Centre for Addiction and Mental Health, 250, College Street, M5T 1R8 Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Remington
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D057565:Apathy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: Avolition-Apathy; Functional outcome; Negative symptoms; Primary symptoms; Psychosocial functioning; Schizophrenia