Negative symptoms and therapy strategies in schizophrenia

Excerpt

In schizophrenia, negative symptoms are associated with poor functional outcome and psychosocial disability. Current treatment with antipsychotics has only limited effects on this symptom domain, and its neurobiological background is only poorly understood. In a comprehensive review, Galderisi et al. [1] focused on the underlying neurobiological basis, including structural and functional neuroimaging data showing alterations in prefronto-temporo-parietal brain circuits, and discuss complex alterations in neurotransmitter systems and genetic variations. However, negative symptoms are a heterogeneous symptom cluster and show also association with cognitive deficits. Garcia-Portilla et al. [2] reviewed the available instruments for assessing the negative syndrome, considering strength and weaknesses of psychometric evaluations such as first-generation scales (BPRS, SANS, PANSS, NSA) and second-generation instruments (BNSS CAINS and MAP-SR). Especially with respect to assessment of primary negative symptoms, further research is needed. Since effective treatment of negative symptoms is an unmet need in the therapy of schizophrenia, Möller and Czobor [3] with focus on results of meta-analyses, review psychopharmacological treatment options including first- and second-generation antipsychotics. Modern antidepressants and add-on treatment with glutamatergic compounds have demonstrated some efficacy, but results are inconsistent and further research is needed to identify effective treatment of this symptom domain. …