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The impact, assessment, and longitudinal course of negative symptoms of schizophrenia

Centre for Psychiatry

Funding Body: Own Resources
Project Investigator: Stefan Priebe

Overview

Negative symptoms of schizophrenia include blunted affect, avolition, asociality, alogia and anhedonia. These symptoms have been found to have a greater impact of social functioning and quality of life in comparison to other symptoms, and be highly resistant to both pharmacological and conventional psychotherapy treatments.

In an attempt to improve patient outcomes in this area, in 2006 a consensus report was published in an attempt to identify and propose ways to address some of the barriers which may be impeding treatment development. Amongst the issues identified included how we currently assess negative symptoms, and a lack of understanding around symptom prevalence, longitudinal course, and the relationship between individual negative symptoms.

The focus of this PhD will be to attempt to address some of these concerns by examining whether negative symptoms change over time, and if so, how; whether some negative symptoms are more liable to change than others; factors affecting the longitudinal course of negative symptoms; whether developments in the assessment of negative symptoms have created an instrument more sensitive to detecting change and identifying how our clinical assessments of negative symptoms relate to real-world outcomes.

Activities & outputs

A systematic review of the literature examining negative symptoms will be conducted to examine the longitudinal course and relationship between symptoms in outpatient settings. In inpatient settings, multi-level modelling techniques will be utilised to examine the prevalence and change in negative symptoms in an attempt to address some of the methodological issues examining this issue in earlier work.

Regarding symptom assessment, one of the most significant recent developments has been a new assessment tool known as the CAINS. Whilst this new scale addresses a number of conceptual and methodological issues with older tools, it is not clear whether it is more sensitive to detecting changes in negative symptoms, or how they relate to objective indicators of how the individual spends their time. Lastly, the level of service utilisation and symptom severity in outpatient settings, and negative symptoms and initial appraisal of inpatient treatment will be examined to help us further understand the relationship between negative symptoms and their impact.

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