Demyttenaere Koen, Anthonis Elizabeth, Acsai Károly, Correll Christoph U
Psychiatry Research Group, Department of Neurosciences, Faculty of Medicine, University of Leuven, and University Psychiatric Center KU Leuven, Leuven, Belgium.
University Psychiatric Center KU Leuven, Leuven, Belgium.
Front Psychiatry. 2022 Apr 25;13:795866. doi: 10.3389/fpsyt.2022.795866. eCollection 2022.
Schizophrenia is a severe psychiatric disorder with a large symptomatic heterogeneity. Moreover, many patients with schizophrenia present with comorbid psychiatric symptoms or disorders. The relation between depressive symptoms and negative symptoms, such as blunted affect, alogia, anhedonia, asociality and avolition, is particularly intriguing. The negative symptoms can be primary or secondary of depression or overlapping with depressive symptoms. The aim of the present network analysis was to better understand the interactions between depressive symptoms and the different symptoms of schizophrenia and to investigate whether negative symptoms and depressive symptoms can be better delineated.
A network analysis on the baseline item scores of the Positive and Negative Syndrome Scale (PANSS) and Calgary Depression Scale for Schizophrenia (CDSS) from the cariprazine-risperidone study in patients with predominant negative symptoms (PNS) was performed. The connections between all these symptoms (PANSS and CDSS) were investiged: node strength and network centrality were estimated and the Mohr 5-factor model of the PANSS was applied to test the validity of its different symptoms clusters.
Across 460 patients with schizophrenia and PNS, the most central symptom (largest node strength) was depression (PANSS) followed by depression (CDSS), anxiety, lack of judgment and insight and tension. The PANSS negative symptom cluster together and was only poorly connected with CDSS depresson symptoms. The Mohr 5 factor model was clearly recognized in the overall clustering of symptoms.
This network analysis suggests that depression and anxiety symptoms are the most central in this PNS patient population, despite the baseline low depression scores, and that negative symptoms are a clearly independent symptom cluster that can be delineated from depressive symptoms.
精神分裂症是一种严重的精神疾病，症状具有很大的异质性。此外，许多精神分裂症患者还伴有共病的精神症状或障碍。抑郁症状与阴性症状（如情感迟钝、言语贫乏、快感缺失、社交退缩和意志缺乏）之间的关系尤其引人关注。阴性症状可能是抑郁的原发性或继发性症状，也可能与抑郁症状重叠。本网络分析的目的是更好地理解抑郁症状与精神分裂症不同症状之间的相互作用，并研究阴性症状和抑郁症状是否能得到更好的区分。
对卡立哌唑-利培酮治疗以阴性症状为主的患者的研究中，对阳性和阴性症状量表（PANSS）和精神分裂症卡尔加里抑郁量表（CDSS）的基线项目得分进行网络分析。研究了所有这些症状（PANSS和CDSS）之间的联系：估计了节点强度和网络中心性，并应用PANSS的莫尔五因素模型来检验其不同症状集群的有效性。
在460例以阴性症状为主的精神分裂症患者中，最核心的症状（最大节点强度）是抑郁（PANSS），其次是抑郁（CDSS）、焦虑、缺乏判断力和洞察力以及紧张。PANSS阴性症状集群聚集在一起，与CDSS抑郁症状的联系较弱。莫尔五因素模型在症状的总体聚类中得到了清晰的识别。
该网络分析表明，尽管基线抑郁评分较低，但抑郁和焦虑症状在以阴性症状为主的患者群体中最为核心，且阴性症状是一个可与抑郁症状区分开来的明显独立的症状集群。
