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Bitter I, Mohr P, Raspopova N, Szulc A, Samochowiec J, Micluia IV, Skugarevsky O, Herold R, Mihaljevic-Peles A, Okribelashvili N, Dragašek J, Adomaitiene V, Rancans E, Chihai J, Maruta N, Marić NP, Milanova V, Tavčar R, Mosolov S. Assessment and Treatment of Negative Symptoms in Schizophrenia-A Regional Perspective. Front Psychiatry 2021; 12:820801. [PMID: 35185643 PMCID: PMC8855151 DOI: 10.3389/fpsyt.2021.820801] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/17/2021] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Istvan Bitter
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - Pavel Mohr
- Clinical Center, National Institute of Mental Health, Klecany, Czechia.,Third Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - Natalia Raspopova
- Department of Psychiatry, Narcology and Neurology of Kazakh-Russian Medical University, Almaty, Kazakhstan
| | - Agata Szulc
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Ioana Valentina Micluia
- Discipline of Psychiatry, Department of Neurosciences, University of Medicine and Pharmacy, Iuliu Haieganu, Cluj-Napoca, Romania
| | - Oleg Skugarevsky
- Department of Psychiatry & Medical Psychology, Belarusian State Medical University, Minsk, Belarus
| | - Róbert Herold
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
| | - Alma Mihaljevic-Peles
- Clinical Hospital Centre Zagreb and School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Nino Okribelashvili
- Department of Psychiatry and Medical Psychology, Tbilisi State University, Tbilisi, Georgia
| | - Jozef Dragašek
- First Department of Psychiatry, University of P. J. Safarik, Medical Faculty and University Hospital of L. Pasteur, Kosice, Slovakia
| | - Virginija Adomaitiene
- Department of Psychiatry, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Elmars Rancans
- Department of Psychiatry and Narcology, Riga Stradins University, Riga, Latvia
| | - Jana Chihai
- Medical Psychology and Narcology Department, State Medical and Pharmaceutical University Nicolae Testemitanu, Chisinau, Moldova
| | - Natalia Maruta
- Department of Borderline Psychiatry, Institute of Neurology, Psychiatry and Narcology of the National Academy of Medical Science of Ukraine, Kharkiv, Ukraine
| | - Nadja P Marić
- Faculty of Medicine University of Belgrade & Institute of Mental Health, Belgrade, Serbia
| | - Vihra Milanova
- Psychiatric Clinic, University Hospital "Alexandrovska", Sofia, Bulgaria
| | - Rok Tavčar
- University Psychiatric Clinic Ljubljana and School of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Sergey Mosolov
- Department for Therapy of Mental Disorders, Moscow Research Institute of Psychiatry, Moscow, Russia.,Department of Psychiatry, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
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