Buschner Maximilian, Dürsteler Kenneth M, Fischli Gina, Hess Jelena, Kirschner Matthias, Kaiser Stefan, Herdener Marcus
Center for Addictive Disorders, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland.
Front Psychiatry. 2022 Nov 18;13:957924. doi: 10.3389/fpsyt.2022.957924. eCollection 2022.
Alcohol Use Disorder (AUD) is characterized by a reduction in goal-directed behavior, with alcohol use taking precedence over other areas of life. These features in AUD resemble negative symptoms in schizophrenia, especially the reduction in motivation and pleasure (MAP). Given the clinical similarities of negative symptoms across diagnostic categories, it comes as a surprise that there are few investigations on negative symptoms in alcohol and other substance use disorders. To our knowledge, our study is the first to assess negative symptoms in AUD based on a two-factorial approach, and to investigate the interrelation of these dimensions with the severity of AUD, and alcohol craving.
We examined a sample of 42 patients with AUD at the Psychiatric University Hospital in Zurich. Participants provided self-report and interview-based measures of the severity of AUD, negative symptoms, and alcohol craving. Finally, we used data from the electronic health records of the patients.
Patients with AUD show negative symptoms to a similar extent as patients with schizophrenia or bipolar disorder. We found a positive correlation between the extent of impairment within the MAP factor and overall severity of AUD. Furthermore, MAP negative symptoms were correlated with alcohol craving. In a linear regression, negative symptoms predicted alcohol craving whereas depression did not.
Negative symptoms as conceptualized for schizophrenia are prevalent in patients with AUD and associated with the severity of AUD. More specifically, severity of AUD correlates with diminished motivation and pleasure, highlighting the importance of disturbances in motivational functions in AUD. This is further supported by the correlation between negative symptoms and craving, a hallmark of AUD. Taken together, our findings suggest that negative symptoms might be a highly relevant but hitherto often neglected therapeutic target in AUD.
酒精使用障碍（AUD）的特征是目标导向行为减少，饮酒优先于生活的其他方面。AUD的这些特征类似于精神分裂症的阴性症状，尤其是动机和快感减退（MAP）。鉴于不同诊断类别中阴性症状的临床相似性，令人惊讶的是，对酒精及其他物质使用障碍中的阴性症状研究较少。据我们所知，我们的研究是首次基于双因素方法评估AUD中的阴性症状，并研究这些维度与AUD严重程度及酒精渴望之间的相互关系。
我们在苏黎世大学精神病医院检查了42名AUD患者的样本。参与者提供了基于自我报告和访谈的AUD严重程度、阴性症状及酒精渴望的测量数据。最后，我们使用了患者电子健康记录中的数据。
AUD患者出现阴性症状的程度与精神分裂症或双相情感障碍患者相似。我们发现MAP因素内的损害程度与AUD的总体严重程度呈正相关。此外，MAP阴性症状与酒精渴望相关。在线性回归中，阴性症状可预测酒精渴望，而抑郁则不能。
精神分裂症概念中的阴性症状在AUD患者中普遍存在，并与AUD的严重程度相关。更具体地说，AUD的严重程度与动机和快感减退相关，突出了AUD中动机功能障碍的重要性。阴性症状与渴望（AUD的一个标志）之间的相关性进一步支持了这一点。综上所述，我们的研究结果表明，阴性症状可能是AUD中一个高度相关但迄今经常被忽视的治疗靶点。
