Unmet needs in treatment of schizophrenia’s negative symptoms – Part 2

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Last month, we explored paranoid schizophrenia and its negative symptoms as defined by Nancy Andreasen. These symptoms, such as affective flattening, alogia, avolition-apathy, anhedonia-asociality, and attention difficulties, pose a significant challenge in schizophrenia management. Consultant Psychiatrist Dr. Stephen McWilliams delves into the treatment options and challenges associated with these symptoms.




In the realm of schizophrenia, there exists a distinction between primary and secondary negative symptoms. Primary symptoms represent enduring deficits that predict a poor prognosis, while secondary symptoms arise as a consequence of various factors such as substance misuse, medication side effects, and social deprivation. Addressing these symptoms is crucial as they significantly impact the functional outcome and quality of life of individuals with schizophrenia.





Effective management of negative symptoms involves early intervention programs to identify and treat evolving psychosis, as well as adherence to clinical practice guidelines for schizophrenia treatment. While antipsychotic medication plays a significant role in symptom management, challenges such as side effects and treatment resistance need to be addressed. Additionally, psychosocial treatments, including social skills training and vocational rehabilitation, can contribute to overall recovery.



Despite the advancements in schizophrenia treatment, there are still unmet needs in addressing negative symptoms. Early diagnosis, patient engagement, and access to comprehensive care remain crucial for improving outcomes in individuals with schizophrenia. By adopting a collaborative and recovery-focused approach, we can strive towards providing a fulfilling life for those affected by this complex condition.



Author
Dr. Stephen McWilliams is a consultant psychiatrist, author, and Associate Clinical Professor at the School of Medicine and Medical Sciences, University College Dublin. He leads the Psychosis Programme at Saint John of God Hospital in Dublin.



References



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  2. Health Service Executive (June 2019). National Clinical Programme for Early Intervention in Psychosis. Model of Care. ISBN 978-1-78602-128-1. (See also Executive Summary. ISBN 978-78602-129-8).

  3. Keating D, McWilliams S, Schneider I, Hynes C, Cousins G, Strawbridge J, Clarke M. Pharmacological guidelines for schizophrenia: a systematic review and comparison of recommendations for the first episode. BMJ Open 7: e013881. doi:10.1136/bmjopen-2016-013881.

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  6. Lally J, Ajnakina O, Stubbs B, Cullinane M, Murphy KC, Gaughran F, Murray RM. Remission and recovery from first-episode psychosis in adults: systematic review and meta-analysis of long-term outcome studies. British Journal of Psychiatry (2017). 211(6):350-8.

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