Symptom patterns and subgrouping of schizophrenic patients: significance of negative symptoms assessed on admission

Schizophr Res. 2002 Jul 1;56(1-2):105-19. doi: 10.1016/s0920-9964(01)00251-1.

Abstract

This study subgroups schizophrenic patients based on symptoms assessed on admission and examines the validity of the subgrouping using follow-up data and other clinical outcome variables. Schizophrenic patients (n=163) from consecutive admission received ratings on the positive and negative syndrome scale (PANSS) on admission and during a 1-year follow-up course. An exploratory graphic analysis on the admission PANSS derived four symptom dimensions: negative symptoms, disorganized thought, hostility/excitement and delusions/hallucinations. This yielded two subgroups of patients on admission, a group with marked negative (GWNEG) and a group without marked negative (GONEG) symptoms. Compared with the GONEG, the GWNEG had a poorer recovery rate, more impairment in attention, a slower response of the delusion/hallucination symptoms to neuroleptic treatment and a longer duration of index hospitalization. At a one-year follow-up, the GWNEG assessed on admission had persistently higher scores on the negative symptom and disorganized thought syndromes, less relapse rate, a shorter duration on job, as well as worse social functioning than the GONEG. Thus, the GONEG might comprise patients having a pure paranoid syndrome with quick and better treatment response, while the GWNEG comprises patients with the blunt-disorganization syndrome having a poorer outcome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Depression / classification
  • Depression / diagnosis*
  • Depression / psychology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Patient Admission
  • Prospective Studies
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Psychometrics
  • Schizophrenia / classification
  • Schizophrenia / diagnosis*
  • Schizophrenic Psychology*