Department of Psychiatry, Stellenbosch University, South Africa.
Department of Psychiatry, Stellenbosch University, South Africa.
Schizophr Res. 2022 May;243:17-23. doi: 10.1016/j.schres.2022.02.017. Epub 2022 Feb 25.
Recent studies suggest a two-factor structure for negative symptoms as assessed by the Positive and Negative Syndrome Scale (PANSS) in schizophrenia, namely experiential and expressive subdomains. Little is known about their clinical correlates and treatment trajectories.
We sought to replicate the two factor-analysis derived subdomains for PANSS negative symptoms in schizophrenia and to assess their independent demographic, premorbid and treatment-related characteristics.
This was a longitudinal study of 106 minimally treated participants with a first episode of a schizophrenia spectrum disorder who received treatment with flupenthixol decanoate 2-weekly injections over two years. Factor analysis was used to characterize the PANSS negative symptom subdomains and linear mixed-effect models for continuous repeated measures were constructed to assess the temporal relations between the negative symptom subdomains and premorbid and treatment related variables.
Factor analysis confirmed a two-factor solution for experiential and expressive subdomains of negative symptoms, although they were strongly correlated. The treatment response trajectories for the two subdomains did not differ significantly, and neither subdomain was significantly associated with our premorbid variables. We found significant main effects for disorganised symptoms and extrapyramidal symptoms on the expressive subdomain, and for disorganised symptoms and depressive symptoms on the experiential subdomain. Post-hoc testing indicated that reductions in HDL-cholesterol levels were associated with less improvement in both expressive and experiential subdomain scores.
The two negative symptom subdomains are closely related, have similar premorbid correlates and respond similarly to antipsychotic treatment. Depression affects the experiential subdomain, whereas extrapyramidal symptoms affect the expressive subdomain.
最近的研究表明，阳性和阴性综合征量表（PANSS）评估精神分裂症的阴性症状存在双因素结构，即体验和表达子领域。关于它们的临床相关性和治疗轨迹知之甚少。
我们试图复制精神分裂症 PANSS 阴性症状的双因素分析衍生的子领域，并评估它们独立的人口统计学、病前和治疗相关特征。
这是一项纵向研究，共纳入 106 名首次发作精神分裂症谱系障碍的患者，他们在两年内接受氟哌噻吨癸酸酯 2 周注射治疗。使用因子分析来描述 PANSS 阴性症状的子领域，并用线性混合效应模型构建连续重复测量来评估阴性症状子领域与病前和治疗相关变量之间的时间关系。
因子分析证实了体验和表达子领域的双因素解决方案，尽管它们之间存在很强的相关性。两个子领域的治疗反应轨迹没有显著差异，而且两个子领域都与我们的病前变量没有显著关联。我们发现，紊乱症状和锥体外系症状对表达子领域有显著的主要影响，而紊乱症状和抑郁症状对体验子领域有显著的主要影响。事后检验表明，高密度脂蛋白胆固醇水平降低与表达和体验子领域评分的改善程度均降低有关。
这两个阴性症状子领域密切相关，具有相似的病前相关性，并且对抗精神病药物治疗的反应相似。抑郁影响体验子领域，而锥体外系症状影响表达子领域。
