#Negative symptoms of schizophrenia manual

Differentiate between primary and secondary negative symptoms by ruling out factors that can cause secondary negative symptoms, such as anxiety/depression, severe positive psychotic symptoms, medication side effects, and substance abuse.

7 Other symptoms may be included in the future as more research is conducted. Among the consensus points that came from the conference was agreement that negative symptoms include (1) blunted affect, (2) alogia, (3) asociality, (4) anhedonia, and (5) avolition. The National Institute of Mental Health (NIMH) sponsored the consensus Development Conference on Negative Symptoms in 2005. In addition, because the SANS and the PANSS were developed in the 1980s, they do not reflect the latest research on negative symptoms. 6 There is some disagreement across these scales as to the negative symptoms that have been included. Those used most commonly in treatment studies are the Scale for the Assessment of Negative Symptoms (SANS) 5 and the Positive and Negative Syndrome Scale (PANSS). In treatment trials, negative symptoms are defined according to rating scales. 4 Recognizing the need for improved assessment and treatment of negative symptoms in schizophrenia, researchers developed negative symptom rating scales. Avolition in schizophrenia was noted as early as the mid-1800s, with Griesinger’s description of patients with psychosis and “a loss of will.” 2 Later, Kraepelin spoke of “a weakening of . . . the mainsprings of volition.” 3 Although many patients with schizophrenia do not have avolition, 1 or more negative symptoms were found in over 50% of outpatients with antipsychotic-treated schizophrenia spectrum disorders. In schizophrenia, negative symptoms are thought to be part of the illness, at least in some patients.

#Negative symptoms of schizophrenia manual

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5) criteria for schizophrenia include negative symptoms, which are defined as affective flattening, alogia, or avolition. Negative symptoms are an absence of or significant decrease in a behavior or psychological function, but this definition could include aphasia from a stroke or sensory neglect. © Copyright 2014 Physicians Postgraduate Press, Inc. This distinction may facilitate the development of new treatments. On most rating scales, negative symptoms have also been found to load onto 1 of 2 domains, apathy/anhedonia/asociality or diminished expression (blunted affect and alogia). Secondary negative symptoms may be caused by comorbid conditions, psychotic symptoms, medication side effects, and substance abuse. Clinicians should differentiate between primary and secondary negative symptoms in order to select the best treatment option.

The most widely used rating scales for negative symptoms (the Scale for the Assessment of Negative Symptoms and the Positive and Negative Syndrome Scale) were developed in the 1980s, but more recent findings, such as insight into aspects of anhedonia, have led to the creation of new rating scales (the Clinical Assessment Interview for Negative Symptoms and the Brief Negative Symptom Scale). Negative symptoms in schizophrenia, such as blunted affect, alogia, asociality, anhedonia, and avolition, remain challenging to treat in many patients, but new concepts may lead to a better understanding of the definition and treatment of these symptoms. Developing Concepts in Negative Symptoms: Primary vs Secondary and Apathy vs Expression