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Study Shows Significant Improvement in Schizophrenia Patients with Predominant Negative Symptoms in Slovakia

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A recent longitudinal, prospective cohort study conducted in Slovakia has revealed promising results for patients with schizophrenia and predominant negative symptoms (PNS). The study, which spanned one year, demonstrated significant improvements in negative symptoms and overall functionality among the participants, highlighting the potential of targeted treatment strategies.

Negative symptoms in schizophrenia, which include anhedonia, alogia, avolition, asociality, and affective flattening, are often more challenging to treat than positive symptoms like delusions and hallucinations. These symptoms severely impair patients’ psychosocial functioning and quality of life, making effective management crucial.

The study, published in the journal European Psychiatry, involved 188 adult outpatients diagnosed with schizophrenia according to ICD-10 criteria. All participants exhibited predominant negative symptoms based on the European Psychiatric Association’s (EPA) guidance. The study was conducted across 20 sites in Slovakia, with follow-up visits at three, six, and twelve months.

Most patients received polytherapy, with cariprazine being the most frequently used antipsychotic, both as monotherapy (20%) and in combination with other medications (76%). Non-pharmacological therapies, including supportive psychotherapy, social skills training, and occupational therapy, were also widely employed.

The study used a number of scales to see how well the treatments worked. These included the m-SAND scale, the PSP scale, the SNS scale, the personalised Short Assessment of Negative Domain, and the CGI-S and CGI-I scales for clinical global impression severity and improvement.

The results were encouraging. The mean m-SAND score decreased significantly from 23.6 at baseline to 13.8 after one year, indicating a substantial reduction in negative symptoms. This improvement was consistent across both the positive and negative sub-scales of the m-SAND, with statistically significant changes observed from the first follow-up visit onward.

According to the SNS scale, which recorded a 12-point decrease in the total score, patients’ self-reported negative symptoms also showed significant improvement. Both physicians and patients noted similar trends in the severity of symptoms, underscoring the reliability of these findings.

Improvements were not limited to symptom reduction. Patients’ functionality, as measured by employment status and PSP scores, also showed notable gains. At the end of the study, fewer patients were unemployed (53% compared to 64% at baseline), and more were engaged in occasional or part-time work.

Additionally, the study observed a significant increase in patients’ insight into their condition. By the end of the year, the proportion of patients with full insight had more than doubled, from 20% to 45%, while those with no insight decreased dramatically.

These findings have broader implications for the treatment of schizophrenia, particularly for patients with PNS. The study underscores the effectiveness of combining pharmacological and non-pharmacological treatments, with cariprazine playing a central role in the therapeutic regimen. This aligns with current treatment guidelines that recommend cariprazine as a first-line medication for managing negative symptoms in schizophrenia.

The continuous improvement observed throughout the one-year period, without any plateauing, suggests that long-term, consistent treatment is essential for managing PNS effectively.

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