CHU de Caen, Service de Psychiatrie, 14000 Caen, France; Normandie Univ, UNICAEN, ISTS, GIP Cyceron, 14000 Caen, France; Normandie Univ, UNICAEN, UFR de Médecine, 14000 Caen, France.
CHU de Caen, Service de Psychiatrie, 14000 Caen, France.
Schizophr Res. 2019 Sep;211:51-55. doi: 10.1016/j.schres.2019.07.012. Epub 2019 Jul 22.
Negative symptoms can be present at any stage of schizophrenia but their evaluation remains challenging. Self-evaluations may be particularly useful in screening negative symptoms quickly and effectively. The purpose of this study was to determine the sensitivity, the specificity, and the threshold beyond which the negative symptoms are considered pathological in a comparative study between patients with schizophrenia and healthy subjects using the Self-assessment of Negative Symptoms (SNS).
One hundred and nine patients with schizophrenia and schizoaffective disorders (DSM-5) and 99 healthy controls were included and evaluated with the SNS. AUROC analyses were performed to assess the discriminant performance of the SNS scale for screening negative symptoms in the whole sample of patients but also in 2 patient sub-samples without high scores of depression or negative symptoms.
The SNS (AUROC = 0.942 ± 0.046; p < 0.001) appears to be an appropriate screening tool for distinguishing between SZ and HC with a threshold value of 7, and the sensitivity and specificity were 92.7% (95CI = [86.1-96.8]) and 85.9% (95CI = [77.4-92.1]) respectively. A threshold at 7 was also observed in the samples without patients with high level of depressive or negative symptoms.
These results indicate that SNS might be a valuable tool for screening negative symptoms in clinical practice regardless the level of depressive and negative symptoms. Further studies using SNS in subjects at high risk for psychosis or with a first psychotic episode would be useful in the detection of negative symptoms.
阴性症状可出现在精神分裂症的任何阶段，但对其评估仍然具有挑战性。自我评价可能特别有助于快速有效地筛选阴性症状。本研究的目的是使用自我评估阴性症状量表（SNS）在精神分裂症患者和健康受试者的比较研究中，确定阴性症状的敏感性、特异性和阈值得分，超过该得分则认为存在病理性阴性症状。
共纳入 109 例精神分裂症和分裂情感障碍患者（DSM-5）和 99 例健康对照者，并使用 SNS 进行评估。进行 AUROC 分析以评估 SNS 量表在所有患者样本中筛选阴性症状的判别性能，同时还在没有高抑郁或阴性症状评分的 2 个患者亚组样本中进行评估。
SNS（AUROC=0.942±0.046；p<0.001）似乎是一种区分 SZ 和 HC 的适当筛查工具，其阈值为 7，敏感性和特异性分别为 92.7%（95CI=[86.1-96.8]）和 85.9%（95CI=[77.4-92.1]）。在没有高抑郁或阴性症状评分的患者样本中也观察到了 7 的阈值。
这些结果表明，无论抑郁和阴性症状的水平如何，SNS 可能都是临床实践中筛选阴性症状的有价值工具。在有精神病高危人群或首次出现精神病性发作的受试者中使用 SNS 进行进一步研究，有助于检测阴性症状。
