Nathan Kline Institute, United States of America; Manhattan Psychiatric Center, United States of America; Medgar Evers College, CUNY, United States of America.
Manhattan Psychiatric Center, United States of America; New School for Social Research, United States of America.
Schizophr Res. 2020 Oct;224:159-166. doi: 10.1016/j.schres.2020.08.008. Epub 2020 Oct 15.
Clinician-administered measures of negative symptoms may not capture patients' subjective experiences. The Self-Evaluation of Negative Symptoms (SNS) has shown good psychometric properties when used in outpatients with higher-level functioning schizophrenia. We aimed to evaluate the psychometric properties of the SNS in low functioning participants with treatment-resistant schizophrenia (TRS).
Participants were assessed using the following measures at two time-points; time-point 1: SNS, Wide Range Achievement Test, 4th Edition Reading Subtest (WRAT-4), and Brief Assessment of Cognition in Schizophrenia (BACS). Time-point 2 (within a week of time-point 1): SNS, Negative Symptom Assessment 16 items (NSA-16), Scale to Assess Unawareness in Mental Disorder-Abbreviated (SUMD-A), Clinical Global Impression Severity Scale (CGI-S), Simpson Angus Scale (SAS), Calgary Depression Scale for Schizophrenia (CDSS), and the Patient Feasibility Questionnaire.
Fifty participants with TRS were enrolled, a mean age of 43.8 years (SD = 11.19, min = 25, max = 64), a mean IQ of 80.62 (SD = 17.12, min = 65, max = 110), and a mean BACS Composite T-Score of 14.08 (SD = 17.16, min = -27, max = 49). Participants responded to SNS prompts with moderate consistency across two time-points. There were no significant correlations between the SNS and the NSA-16 Global Symptom score (Pearson r = 0.207, p = .150, Spearman r = 0.101, p = .483), NSA-16 Global Functioning score (Pearson r = 0.209, p = .145, Spearman r = 0.126, p = .384), nor the NSA-16 total score (Pearson r = 0.149, p = .302, Spearman r = 0.116, p = .421). However, when participants were stratified by BACS Composite T-score, there was a significant positive correlation between the SNS total and the NSA-16 Global Functioning score (Pearson r = 0.500, p = .048, Spearman r = 0.546, p = .029) among participants who demonstrated higher cognitive functioning.
Participants with TRS and low functioning were able to respond to questions on the SNS regarding their subjective assessment of negative symptoms. However, self-reported and clinician-rated negative symptoms were not equivalent, except in a subgroup with higher cognitive functioning. This discrepant self-reporting appeared to relate to their low levels of insight and cognitive impairments.
临床医生管理的阴性症状量表可能无法捕捉到患者的主观体验。自我评估阴性症状量表（SNS）在具有较高功能水平的精神分裂症门诊患者中表现出良好的心理计量学特性。我们旨在评估 SNS 在治疗抵抗性精神分裂症（TRS）低功能患者中的心理计量学特性。
参与者在两个时间点使用以下措施进行评估：时间点 1：SNS、广泛成就测试，第 4 版阅读子测验（WRAT-4）和简明精神分裂症认知评估量表（BACS）。时间点 2（在时间点 1 的一周内）：SNS、阴性症状评估 16 项（NSA-16）、精神障碍意识评估量表简化版（SUMD-A）、临床总体印象严重程度量表（CGI-S）、辛普森安格斯量表（SAS）、卡尔加里精神分裂症抑郁量表（CDSS）和患者可行性问卷。
共有 50 名 TRS 参与者入组，平均年龄 43.8 岁（标准差=11.19，最小值=25，最大值=64），平均智商为 80.62（标准差=17.12，最小值=65，最大值=110），平均 BACS 综合 T 分数为 14.08（标准差=17.16，最小值=-27，最大值=49）。参与者在两个时间点对 SNS 提示的回答具有中等一致性。SNS 与 NSA-16 总体症状评分（Pearson r=0.207，p=0.150，Spearman r=0.101，p=0.483）、NSA-16 总体功能评分（Pearson r=0.209，p=0.145，Spearman r=0.126，p=0.384）或 NSA-16 总分（Pearson r=0.149，p=0.302，Spearman r=0.116，p=0.421）之间均无显著相关性。然而，当根据 BACS 综合 T 分数对参与者进行分层时，在认知功能较高的参与者中，SNS 总分与 NSA-16 总体功能评分之间存在显著正相关（Pearson r=0.500，p=0.048，Spearman r=0.546，p=0.029）。
TRS 和低功能的参与者能够回答 SNS 关于其阴性症状主观评估的问题。然而，自我报告和临床医生评定的阴性症状并不相等，除了在认知功能较高的亚组中。这种不一致的自我报告似乎与他们的低洞察力和认知障碍有关。
