Differentiating Primary From Secondary Negative Symptoms in Schizophrenia: A Study of Neuroleptic-Naive Patients Before and After Treatment

OBJECTIVE: The study examined the primary versus secondary character of negative symptoms in a group of first-episode, neuroleptic-naive psychotic patients before and after they started neuroleptic treatment. METHOD: Forty-seven inpatients with a first episode of schizophrenia or related psychotic d...

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Bibliographic Details
Published in:The American journal of psychiatry 2000-09, Vol.157 (9), p.1461-1466
Main Authors: Peralta, Victor, Cuesta, Manuel J., Martinez-Larrea, Alfredo, Serrano, Jose F.
Format: Article
Language:English
Subjects:
Adult
Antipsychotic Agents - adverse effects
Antipsychotic Agents - therapeutic use
Antipsychotic drugs
Biological and medical sciences
Comorbidity
Depressive Disorder - diagnosis
Depressive Disorder - epidemiology
Diagnosis, Differential
Female
Follow-Up Studies
Hospitalization
Humans
Male
Medical sciences
Neuropharmacology
Parkinson Disease - diagnosis
Parkinson Disease - epidemiology
Parkinson Disease, Secondary - chemically induced
Parkinson Disease, Secondary - diagnosis
Parkinson Disease, Secondary - epidemiology
Patients
Pharmacology. Drug treatments
Probability
Psychiatric Status Rating Scales - statistics & numerical data
Psychiatry
Psycholeptics: tranquillizer, neuroleptic
Psychology. Psychoanalysis. Psychiatry
Psychopharmacology
Regression Analysis
Schizophrenia
Schizophrenia - diagnosis
Schizophrenia - drug therapy
Schizophrenia - epidemiology
Schizophrenic Psychology
Severity of Illness Index
Spain - epidemiology
Symptoms
Treatment Outcome
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Summary:OBJECTIVE: The study examined the primary versus secondary character of negative symptoms in a group of first-episode, neuroleptic-naive psychotic patients before and after they started neuroleptic treatment. METHOD: Forty-seven inpatients with a first episode of schizophrenia or related psychotic disorders were examined for the presence of negative symptoms, psychosis, depression, and parkinsonism at admission to an inpatient psychiatric unit, before receiving neuroleptics, and at discharge an average 3.3 weeks later, after starting neuroleptic treatment. RESULTS: Although patients' mean scores on measures of positive, negative, and depressive symptoms decreased significantly over the treatment period, the mean rating of nonakinetic parkinsonism worsened. The mean rating of akinetic parkinsonism did not change significantly over the treatment period. Negative symptoms at admission were not predicted by positive or depressive symptoms at admission. Residual negative symptoms at discharge were mainly predicted by negative symptoms at admission (i.e., primary symptoms) and to a negligible degree by residual positive and depressive symptoms. Change in negative symptoms over the observation period was predicted to a marginal degree by change in depressive symptoms. CONCLUSIONS: Negative symptoms rated during a first psychotic episode before and after starting antipsychotic treatment are mainly primary in character and should be considered as a direct manifestation of the basic dysfunctions of schizophrenia.
ISSN:0002-953X
1535-7228
DOI:10.1176/appi.ajp.157.9.1461