Historically, negative symptoms of schizophrenia have received little attention however, with an appreciation for the attributable severe impairment, there has been an increased focus on their assessment and management (Galderisi et al., 2021). ![]() These symptoms cause much of the long-term morbidity and poor functional outcomes in people with schizophrenia (Association, A.P., 2013 Rabinowitz et al., 2012) and affect their ability to live independently, perform activities of daily living, maintain personal relationships and participate in social, work and study activities (Novick et al., 2009 Rabinowitz et al., 2012 White et al., 2009). Whilst positive symptoms reflect an excess or distortion of normal function (e.g., delusions, hallucinations, disorganised behaviour), negative symptoms refer to a diminution or absence of normal behaviours (e.g., avolition, anhedonia, asociality) or expression (e.g., blunted affect, alogia) (Correll and Schooler, 2020).Īlthough antipsychotic medications, the cornerstone of current therapy, are effective for the treatment of positive symptoms, they have limited efficacy for treating negative symptoms (Erhart et al., 2006). Schizophrenia is characterised by positive and negative symptoms. These are economically devastating to individuals, families and caregivers (Galletly et al., 2016) and are much greater than the direct costs with productivity losses alone accounting for just over half of total costs (Neil et al., 2014). Additionally, significant indirect costs such as lost productivity and unemployment are attributable to schizophrenia. In most developed countries, the direct hospital and community healthcare costs of schizophrenia amount to 1.4 to 2.8% of national health care expenditure and up to 20% of the direct costs of all mental health conditions (Galletly et al., 2016). ConclusionsĬertain psychological, environmental, and treatment-related factors may influence the cumulative impact of negative symptoms, presenting the possibility for early intervention to improve the long-term course.The social and economic costs of schizophrenia are disproportionately high, relative to its incidence and prevalence (Galletly et al., 2016). Each negative symptom decreased from the UHR to FEP stages and then increased from the FEP to MEP stages. For each negative symptom, the prevalences showed a comparable course. We selected 47 studies totaling 1872 UHR, 2947 FEP, 5039 younger MEP, and 669 older MEP patients. For each negative symptom, we averaged and weighted by the combined sample size the prevalences of each negative symptom at each stage. We combined results using the definitions of negative symptoms detailed in the Brief Negative Symptom Scale, a recently developed tool. We searched several databases for studies reporting prevalences of negative symptoms in each one of our predetermined stages of the psychosis continuum: clinical or ultra-high risk (UHR), first-episode of psychosis (FEP), and younger and older patients who have experienced multiple episodes of psychosis (MEP). ![]() Our aim in this review is to compare those prevalences across stages, thereby disclosing the course of negative symptoms. Previous reports have separately investigated the prevalence of negative symptoms within each stage of the psychosis continuum. ![]() While no treatment is currently available to address these symptoms, a more refined characterization of their course over the lifetime could help in elaborating interventions. ![]() Patients in every stage of the psychosis continuum can present with negative symptoms.
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