Bitter Istvan, Mohr Pavel, Raspopova Natalia, Szulc Agata, Samochowiec Jerzy, Micluia Ioana Valentina, Skugarevsky Oleg, Herold Róbert, Mihaljevic-Peles Alma, Okribelashvili Nino, Dragašek Jozef, Adomaitiene Virginija, Rancans Elmars, Chihai Jana, Maruta Natalia, Marić Nadja P, Milanova Vihra, Tavčar Rok, Mosolov Sergey
Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
Clinical Center, National Institute of Mental Health, Klecany, Czechia.
Front Psychiatry. 2022 Feb 4;12:820801. doi: 10.3389/fpsyt.2021.820801. eCollection 2021.
Clinicians and researchers consider that there are a variety of symptoms that constitute negative symptoms in schizophrenia, and they may use different definitions for the same symptoms. These differences are also reflected in a variety of negative symptom rating scales. Both research and clinical work are negatively affected by the lack of consensus regarding the symptoms that constitute negative symptoms in schizophrenia. Leading research groups have investigated ways to reduce heterogeneity in the domain of negative symptoms in schizophrenia; however, little attention has been paid to regional differences in the concepts of negative symptoms in schizophrenia. The objective of this review was to collect and summarize information about the assessment and treatment of negative symptoms of schizophrenia in Central and Eastern Europe (CEE). Nineteen experts from 17 countries in CEE participated in this project. The participants collected information about their countries, including the following: (1) the most important publications about negative symptoms in schizophrenia (irrespective of the time of their publication); (2) the most frequently used negative symptom of schizophrenia in clinical practice; (3) definitions of frequently used negative symptoms; and (4) treatment of negative symptoms in schizophrenia. The participating experts/countries most frequently reported the following five negative symptoms: avolition, blunted affect, alogia, asociality, and anhedonia. Several experts also considered other symptoms as belonging to the negative symptom domain, such as a decrease in energy level and changes in personality. The importance of evaluating the long-term course and the relationship between negative symptoms and other symptom domains was also noted. No noticeable differences were reported in the treatment of negative symptoms compared to currently published guidelines and algorithms. The most frequently reported negative symptoms included those defined by the NIMH-MATRICS consensus statement on negative symptoms and recently endorsed in a guidance paper of the European Psychiatric Association. The main differences in the concepts, names, and definitions of primary negative symptoms, especially those related to personality changes, and to the evaluation of the long-term course and relationship between different symptom domains in CEE compared to the current English language literature deserve the attention of psychiatrists and other professionals in this field.
临床医生和研究人员认为，精神分裂症中有多种症状构成阴性症状，而且他们可能对相同症状采用不同的定义。这些差异也体现在各种阴性症状评定量表中。对于精神分裂症中构成阴性症状的症状缺乏共识，这对研究和临床工作都产生了负面影响。主要研究团队已经在探索减少精神分裂症阴性症状领域异质性的方法；然而，对于精神分裂症阴性症状概念中的区域差异关注甚少。本综述的目的是收集和总结中东欧（CEE）地区精神分裂症阴性症状评估和治疗的相关信息。来自中东欧17个国家的19位专家参与了该项目。参与者收集了有关他们国家的信息，包括以下内容：（1）关于精神分裂症阴性症状的最重要出版物（不论其出版时间）；（2）临床实践中最常用的精神分裂症阴性症状；（3）常用阴性症状的定义；以及（4）精神分裂症阴性症状的治疗。参与的专家/国家最常报告以下五种阴性症状：意志缺乏、情感迟钝、言语贫乏、社交退缩和快感缺失。几位专家还认为其他症状也属于阴性症状范畴，例如精力水平下降和人格改变。还提到了评估阴性症状的长期病程以及阴性症状与其他症状领域之间关系的重要性。与当前发表的指南和算法相比，在阴性症状的治疗方面未报告明显差异。最常报告的阴性症状包括那些由美国国立精神卫生研究所（NIMH）-测量与治疗研究改善精神分裂症认知功能（MATRICS）阴性症状共识声明所定义并最近在欧洲精神病学协会的一份指导文件中得到认可的症状。与当前英文文献相比，中东欧地区原发性阴性症状在概念、名称和定义上的主要差异，尤其是那些与人格改变以及不同症状领域的长期病程评估和关系相关的差异，值得该领域的精神科医生和其他专业人员关注。
