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Stability of positive and negative symptoms in schizophrenic patients: a 3-year follow-up study

Published online by Cambridge University Press:  16 April 2020

S Dollfus  and
M Petit
S Dollfus
Affiliation:
Centre Esquirol, CHU de Caen, 14000Caen
M Petit
Affiliation:
Department of Psychiatry, University of Rouen, Centre Hospitalier du Rouvray, 4 rue Paul Eluard, 76301Sotteville les Rouen, France
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Summary

The course of negative and positive symptoms was studied in neuroleptic-treated patients over a 3-year period, in consideration also of the initial phase of illness (post-acute or chronic). This study was carried out in a broadly defined schizophrenic sample, in order not to give preference to one diagnostic subgroup over another. Forty-six patients were evaluated every year for 3 years, 23 in the post-acute group and 23 in the chronic group. Aggravations of the Clinical Global Impression (CGI) and of the SANS total score were observed, regardless of the group (chronic or post-acute). This global aggravation confirmed Kraepelin's concept of dementia praecox; moreover, this aggravation was not due to an increase in the number of patients relapsing, or to an aggravation of akinesia. Three types of negative and positive symptom courses were observed: i) the mean sub-scores of positive symptoms, such as hallucinations, delusions, positive formal thought disorders, and of negative symptoms such as flattening affect, avolition/apathy and attentional impairment, did not vary significantly over time in either group; ii) the mean sub-scores of bizarre behavior and alogia fluctuated over time (p < 0.05) and only poverty of speech was perfectly stable among the items constituting alogia; iii) the mean subscores of anhedonia/asociality worsened significantly over time irrespective of the groups (p < 0.05), and among the items constituting anhedonia, recreational interest-activities and intimacy-closeness abilities worsened (p < 0.05 and p < 0.01, respectively). This aggravation was neither due to an increase in neuroleptic doses nor to the duration and chronicity of illness. However, negative symptoms, except anhedonia, can be reversible in some patients. The very strong stability of anhedonia, whatever the group, emphasize the importance of taking anhedonia into account in future diagnostic classifications.

Keywords

negative and positive symptomsfollow-upschizophreniaanhedonia
Type
Original article
Information
European Psychiatry , Volume 10 , Issue 5 , 1995 , pp. 228 - 236
Copyright
Copyright © Elsevier, Paris 1995

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References

Addington, J, Addington, DPositive and negative symptoms of schizophrenia. Their course and relationship over time. Schizophrenia Research 1991; 5: 51–59CrossRefGoogle ScholarPubMed
Andreasen, NCPositive and negative symptoms: historical and conceptual aspects. In: Andreasen, NC eds. Schizophrenia: Positive and negative symptoms and syndromes. Modern Problems of Pharmacopsychiatry. New York: Karger, 1990; 41Google Scholar
Andreasen, NC, Grove, WNEvaluation of positive and negative symptoms in schizophrenia. Psychiatry Psychobiol 121986 108–121CrossRefGoogle Scholar
Ban, TADrug treatment in schizophrenia. J Can Psychiat Assoc 1971; 16: 473–485CrossRefGoogle Scholar
Biehl, H, Maurer, K, Jung, E, Krüger, G, Bauer-Schubart, CReported symptoms in schizophrenic patients within five years of the onset of illness. A report from the prospective rhine neckar cohort study. In: Dencker, J, Kulhanek, F eds. Treatment resistance in schizophrenia: an approach for research and clinical routine together with a reconnaissance paper. Braunschweig: Vieweg, 1988; 108–118Google Scholar
Boyer, P, Lecrubier, YFiche descriptive et traduction française de la SAPS. Psychiatr Psychobiol II61987 425–437CrossRefGoogle Scholar
Breier, A, Schreiber, JL, Pickar, DCourse of illness and predictors of outcome in chronic schizophrenia: implications for pathophysiology. Br J Psychiatry 161suppl 181992 38–43CrossRefGoogle Scholar
Carpenter, WT, Heinrichs, RE, Wagman, AMIDeficit and nondeficit forms of schizophrenia: the concept. Am J Psychiatry 1988; 145: 578–583Google ScholarPubMed
Carpenter, WT, Strauss, JS, Bartko, JJFlexible system for diagnosis of schizophrenia: Report from the WHO international pilot study of schizophrenia. Science 1973; 182: 1275–1278CrossRefGoogle ScholarPubMed
Chouinard, G, Chouinard, RA, Annable, L, Jones, BDExtrapyramidal symptom rating scale. Can J Neurol Sci 731980Google Scholar
Ciompi, LThe natural history of schizophrenia in the long term. Br J Psychiatry 1980; 136: 413–420CrossRefGoogle ScholarPubMed
Crow, TJMolecular pathology of schizophrenia: more than one disease process. Br J Psychiatry 1980; 280: 66–68Google ScholarPubMed
Crow, TJThe two-syndrome concept: origins and current status. Schizophr Bull 1985; 11: 471–785CrossRefGoogle ScholarPubMed
Diagnostic and statistical manuel of mental disorders. Third edition revised (DSMIII-R). American Psychiatric Association. Washington DCGoogle Scholar
Dollfus, S, Petit, M, Menard, JFet al.Polydiagnostic approach of schizophrenia: validity of a computer checklist (LIDE) Encephale X 1994 91–102Google Scholar
Dollfus, S, Petit, M, Menard, JF, Lesieur, PRecherche sur la schizophrénie: nécessité d'inclure les patients selon plusieurs systèmes diagnostiques. Ann Med Psychologiques 1992; 150: 327–331Google Scholar
Dollfus, S, Petit, M, Menard, JF, Lesieur, PSchizophrenia: comparison of 13 diagnostic systems in a cross-sectional study. Eur Psychiatry 1993; 8: 7–13Google Scholar
Feighner, JR, Robins, E, Guze, SB, Woodruff, RA, Winokur, G, Simon, RDiagnostic criteria for use in psychiatric research. Arch Gen Psychiatry 1972; 26: 57–63CrossRefGoogle ScholarPubMed
Fenton, WS, McGlashan, THNatural history of schizophrenia subtypes. H. Positive and negative symptoms and long-term course. Arch Gen Psychiatry 1991; 48: 978–986Google Scholar
Foster, PNeuroleptic equivalence. Pharm J 1989; 30: 431–432Google Scholar
Harrow, M, Silverstein, MLPsychotic symptoms in schizophrenia after the acute phase. Schizophr Bull 1977; 3: 608–616Google ScholarPubMed
Harvey, PD, Earle Boyer, EA, Wielgus, MSThe consistency of thought disorder in mania and schizophrenia. J Nerv Ment Dis 1984; 172: 458–463CrossRefGoogle Scholar
Johnstone, EC, Owens, DGC, Frith, CD, Crow, TJThe relative stability of positive and negative features in chronic schizophrenia. Br J Psychiatry 1986; 150: 60–64CrossRefGoogle Scholar
Kay, SR, Fiszbein, A, Lindenmayer, JP, Opler, LAPositive and negative syndromes in schizophrenia as a function of chronicity. Acta Psychiatr Scand 1986; 74: 507–518CrossRefGoogle ScholarPubMed
Kulhara, P, Chandiramani, KPositive and negative subtypes of schizophrenia; a follow-up study from India. Schizophr Res 1990; 3: 107–116CrossRefGoogle ScholarPubMed
Langfeldt, GDiagnosis and prognosis of schizophrenia Proc Roy Soc Med 53 1960; 1047–1052CrossRefGoogle ScholarPubMed
Lecrubier, Y, Boyer, PFiche descriptive et traduction francaise de la SANS. Psychiatr Psychobiol II61987 414–424Google Scholar
Lindenmayer, JP, Kay, SR, Friedman, CNegative and positive schizophrenic syndromes after the acute phase: a prospective follow-up. Comp Psychiatry 2741986 276–286CrossRefGoogle ScholarPubMed
McCreadie, RG, Wiles, D, Grant, Set al.The Scotisch first episode schizophrenia study. VII. Two-year follow-up Acta Psychiatr Scand 80 1989 597–602Google ScholarPubMed
McGlashan, TH, Fenton, WSSubtype progression and pathophysiologies deterioration in early schizophrenia. Schizophr Bull 19(1)1993 71–84CrossRefGoogle Scholar
Mueser, KT, Douglas, MS, Bellack, AS, Morrison, RLAssessment of enduring deficit and negative symptom subtypes in schizophrenia. Schizophr Bull 1741991 565–582CrossRefGoogle Scholar
Nyman, AK, Jonsson, HPatterns of self destructive behavior in schizophrenia. Acta Psychiat Scand 1986; 73: 252–262CrossRefGoogle Scholar
Organisation mondiale de la santé: CIM9 Troubles mentaux: glossaire et guide de la classification en concordance avec la neuvième révision de la classification des maladies. Genève: OMS, 1979Google Scholar
Pogue-Geile, MFThe prognostic significance of negative symptoms in schizophrenia Br J Psychiatry 155suppl 71989 123–127CrossRefGoogle Scholar
Pogue-Geile, MF, Harrow, MNegative symptoms in schizophrenia: their longitudinal course and prognostic importance Schizophr Bull 1131985 427–439CrossRefGoogle ScholarPubMed
Pull, MC, Pull, CB, Pichot, PDes critères empiriques français pour les psychoses. IL Consensus des psychiatres français et définitions provisoires Encéphale XIII 1987 53–57Google Scholar
Pull, MC, Pull, CB, Pichot, PDes critères empiriques français pour les psychoses. III. Algorithmes et arbre de décision Encéphale 1987 59–66Google Scholar
Pull, CB, Pull, MC, Pichot, PL.I.C.E.T.-S: une liste intégrée de critères d'évaluation taxinomiques pour les psychoses nonaffectives. J Psy Biol Therap 1981; 1(1): 33–37Google Scholar
Ragin, AB, Pogue-Geile, M, Oltmanns, TFPoverty of speech in schizophrenia and depression during in-patient and posthospital periods. Br J Psychiatry 1989; 154: 52–57CrossRefGoogle Scholar
Rennie, TACFollow-up study of five hundred patients with schizophrenia admitted to the hospital from 1913 to 1923. Arch Neurol Psychiatry 1939; 42: 877–891CrossRefGoogle Scholar
Robert, P, Benoist, P, Gueniffey, S, Khouri, F, Lagier, C, Darcourt, GÉvolution des psychoses: résultats d'une enquête clinique portant sur 383 cas pendant 10 ans (1975–1985) Ann Med Psychologiques 147 1989 15–33Google Scholar
Schneider, KClinical psychopathology New York: Grune and Stratton, 1959Google Scholar
Spitzer, RL, Endicott, J, Robins, EResearch Diagnostic Criteria. Arch Gen Psychiatry 1978; 35: 773–782CrossRefGoogle ScholarPubMed
Taylor, MA, Abrams, RThe prevalence of schizophrenia: a reassessment using modern diagnostic criteria Am J Psychiatry 13581978 945–948Google ScholarPubMed
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