Wójciak Paweł, Rybakowski Janusz
Klinika Psychiatrii Dorosłych Uniwersytetu Medycznego w Poznaniu.
Psychiatr Pol. 2018 Apr 30;52(2):185-197. doi: 10.12740/PP/70610.
Negative symptoms of schizophrenia constitute a serious diagnostic and therapeutic problem. They substantially account for the impairment of health, social functioning and quality of life whereas treatment is difficult. In this paper the development of the concept of schizophrenia and negative symptoms is presented. The models of positive and negative symptoms, introduced in the 1980's by Timothy Crow and Nancy Andreasen, and William Carpenter's concept of so-called deficit syndrome with the criteria of the division of negative symptoms into the primary and secondary, are discussed. Current views on the pathogenesis of negative symptoms are shown with reference to neuroimaging studies, neurotransmitter alterations, neuropsychological deficits, genetic, immunological and epidemiological studies. A subsection is devoted to the diagnostics tools for negative symptoms. Chronologically, they are divided into scales of the 1st and 2nd generation. The first generation includes: the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Negative Symptoms (SANS), the Positive and Negative Syndrome Scale (PANSS), the Schedule for the Deficit Syndrome (SDS), and the Proxy for Deficit Syndrome. The second generation scales, developed as a result of the recommendation by American experts in 2006, include: the Brief Negative Syndrome Scale (BNSS) and the Clinical Assessment Interview for Negative Symptoms (CAINS), also the self-assessment scales: the Motivation and Pleasure Scale - Self Report (MAP-SR) and the Self-assessment of Negative Symptoms (SNS). The BNSS and the SNS scales, whose Polish versions were elaborated in the Department of Adult Psychiatry of Poznan University of Medical Sciences, are discussed in-depth.
精神分裂症的阴性症状构成了一个严重的诊断和治疗难题。它们在很大程度上导致了健康受损、社会功能障碍和生活质量下降，而治疗却很困难。本文介绍了精神分裂症及阴性症状概念的发展历程。文中讨论了由蒂莫西·克劳和南希·安德烈亚森于20世纪80年代提出的阳性和阴性症状模型，以及威廉·卡彭特提出的所谓缺陷综合征概念，该概念将阴性症状分为原发性和继发性的标准。文中还结合神经影像学研究、神经递质改变、神经心理学缺陷、遗传学、免疫学和流行病学研究，展示了目前对阴性症状发病机制的观点。有一个小节专门讨论阴性症状的诊断工具。按时间顺序，它们分为第一代和第二代量表。第一代包括：简明精神病评定量表（BPRS）、阴性症状评定量表（SANS）、阳性和阴性症状量表（PANSS）、缺陷综合征评定量表（SDS）以及缺陷综合征替代量表。第二代量表是根据美国专家2006年的建议制定的，包括：简明阴性症状量表（BNSS）和阴性症状临床评估访谈（CAINS），还有自我评估量表：动机与愉悦量表 - 自我报告（MAP-SR）和阴性症状自我评估量表（SNS）。文中深入讨论了由波兹南医科大学成人精神病学系精心编制波兰语版本的BNSS和SNS量表。
