Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment

Christoph U Correll, 1–3 Nina R Schooler 4 1The Zucker Hillside Hospital, Division of Psychiatry Research, Northwell Health, Glen Oaks, NY, USA; 2The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, New York, NY, USA; 3C...

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Autores principales:	Correll CU, Schooler NR
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	schizophrenia negative symptoms prevalence clinical presentation diagnosis treatment Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/26f9aac0eef444908757d73b9683ab7a
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spelling	oai:doaj.org-article:26f9aac0eef444908757d73b9683ab7a2021-12-02T05:38:21ZNegative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment1178-2021https://doaj.org/article/26f9aac0eef444908757d73b9683ab7a2020-02-01T00:00:00Zhttps://www.dovepress.com/negative-symptoms-in-schizophrenia-a-review-and-clinical-guide-for-rec-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Christoph U Correll, 1–3 Nina R Schooler 4 1The Zucker Hillside Hospital, Division of Psychiatry Research, Northwell Health, Glen Oaks, NY, USA; 2The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, New York, NY, USA; 3Charité Universitätsmedizin, Department of Child and Adolescent Psychiatry, Berlin, Germany; 4State University of New York, Downstate Medical Center, Brooklyn, NY, USACorrespondence: Christoph U CorrellThe Zucker Hillside Hospital, Division of Psychiatry Research, 75-59 263rd Street, Glen Oaks, NY 11004, USATel +1 718 470-4812Email ccorrell@northwell.eduAbstract: Schizophrenia is frequently a chronic and disabling disorder, characterized by heterogeneous positive and negative symptom constellations. The objective of this review was to provide information that may be useful for clinicians treating patients with negative symptoms of schizophrenia. Negative symptoms are a core component of schizophrenia that account for a large part of the long-term disability and poor functional outcomes in patients with the disorder. The term negative symptoms describes a lessening or absence of normal behaviors and functions related to motivation and interest, or verbal/emotional expression. The negative symptom domain consists of five key constructs: blunted affect, alogia (reduction in quantity of words spoken), avolition (reduced goal-directed activity due to decreased motivation), asociality, and anhedonia (reduced experience of pleasure). Negative symptoms are common in schizophrenia; up to 60% of patients may have prominent clinically relevant negative symptoms that require treatment. Negative symptoms can occur at any point in the course of illness, although they are reported as the most common first symptom of schizophrenia. Negative symptoms can be primary symptoms, which are intrinsic to the underlying pathophysiology of schizophrenia, or secondary symptoms that are related to psychiatric or medical comorbidities, adverse effects of treatment, or environmental factors. While secondary negative symptoms can improve as a consequence of treatment to improve symptoms in other domains (ie, positive symptoms, depressive symptoms or extrapyramidal symptoms), primary negative symptoms generally do not respond well to currently available antipsychotic treatment with dopamine D 2 antagonists or partial D 2 agonists. Since some patients may lack insight about the presence of negative symptoms, these are generally not the reason that patients seek clinical care, and clinicians should be especially vigilant for their presence. Negative symptoms clearly constitute an unmet medical need in schizophrenia, and new and effective treatments are urgently needed.Keywords: schizophrenia, negative symptoms, prevalence, clinical presentation, diagnosis, treatmentCorrell CUSchooler NRDove Medical Pressarticleschizophrenianegative symptomsprevalenceclinical presentationdiagnosistreatmentNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 16, Pp 519-534 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	schizophrenia negative symptoms prevalence clinical presentation diagnosis treatment Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	schizophrenia negative symptoms prevalence clinical presentation diagnosis treatment Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Correll CU Schooler NR Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment
description	Christoph U Correll, 1–3 Nina R Schooler 4 1The Zucker Hillside Hospital, Division of Psychiatry Research, Northwell Health, Glen Oaks, NY, USA; 2The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Department of Psychiatry and Molecular Medicine, New York, NY, USA; 3Charité Universitätsmedizin, Department of Child and Adolescent Psychiatry, Berlin, Germany; 4State University of New York, Downstate Medical Center, Brooklyn, NY, USACorrespondence: Christoph U CorrellThe Zucker Hillside Hospital, Division of Psychiatry Research, 75-59 263rd Street, Glen Oaks, NY 11004, USATel +1 718 470-4812Email ccorrell@northwell.eduAbstract: Schizophrenia is frequently a chronic and disabling disorder, characterized by heterogeneous positive and negative symptom constellations. The objective of this review was to provide information that may be useful for clinicians treating patients with negative symptoms of schizophrenia. Negative symptoms are a core component of schizophrenia that account for a large part of the long-term disability and poor functional outcomes in patients with the disorder. The term negative symptoms describes a lessening or absence of normal behaviors and functions related to motivation and interest, or verbal/emotional expression. The negative symptom domain consists of five key constructs: blunted affect, alogia (reduction in quantity of words spoken), avolition (reduced goal-directed activity due to decreased motivation), asociality, and anhedonia (reduced experience of pleasure). Negative symptoms are common in schizophrenia; up to 60% of patients may have prominent clinically relevant negative symptoms that require treatment. Negative symptoms can occur at any point in the course of illness, although they are reported as the most common first symptom of schizophrenia. Negative symptoms can be primary symptoms, which are intrinsic to the underlying pathophysiology of schizophrenia, or secondary symptoms that are related to psychiatric or medical comorbidities, adverse effects of treatment, or environmental factors. While secondary negative symptoms can improve as a consequence of treatment to improve symptoms in other domains (ie, positive symptoms, depressive symptoms or extrapyramidal symptoms), primary negative symptoms generally do not respond well to currently available antipsychotic treatment with dopamine D 2 antagonists or partial D 2 agonists. Since some patients may lack insight about the presence of negative symptoms, these are generally not the reason that patients seek clinical care, and clinicians should be especially vigilant for their presence. Negative symptoms clearly constitute an unmet medical need in schizophrenia, and new and effective treatments are urgently needed.Keywords: schizophrenia, negative symptoms, prevalence, clinical presentation, diagnosis, treatment
format	article
author	Correll CU Schooler NR
author_facet	Correll CU Schooler NR
author_sort	Correll CU
title	Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment
title_short	Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment
title_full	Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment
title_fullStr	Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment
title_full_unstemmed	Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment
title_sort	negative symptoms in schizophrenia: a review and clinical guide for recognition, assessment, and treatment
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/26f9aac0eef444908757d73b9683ab7a
work_keys_str_mv	AT correllcu negativesymptomsinschizophreniaareviewandclinicalguideforrecognitionassessmentandtreatment AT schoolernr negativesymptomsinschizophreniaareviewandclinicalguideforrecognitionassessmentandtreatment
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Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recognition, Assessment, and Treatment

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