Neurocognitive management of the primary negative symptoms of schizophrenia: a role of atypical antipsychotics.

Patients with schizophrenia have profound and disabling cognitive deficits while negative symptoms represent a separate symptom domain, with respect to depression, neurocognition, and social cognition. Particularly, primary negative symptoms of schizophrenia represent a diagnostic and therapeutic challenge, In this study we try to evaluate the cognitive symptoms in 51 primary negative schizophrenic inpatients by the administration of simple, fast and understandable scales (MMSE, DSST, EpiTrack, PANSS cognitive factor). We also evaluate the correlation with some SGAs (aripiprazole, quetiapine, olanzapine, paliperidone). Our results support the evidence of the use of simple, rapid and acceptable scales for cognitive evaluation in clinical practice. Overall data indicate no statistically significant variations of the negative symptomatology in all the examined sample, although a reduction of the statistical averages in each group is observed (paliperidone and olanzapine, particularly).

Management of primary negative symptoms in schizophrenia: an one-year observational study.

Negative symptoms represent a separate symptom domain, with respect to depression, neurocognition, and social cognition and have a strong direct and indirect impact on real-life functioning. Furthermore, negative symptoms that do not improve following antipsychotic treatment are an important diagnostic and therapeutic challenge. We conducted a 12-month-study open-observational study to evaluate the efficacy of some atypical antipsychotics on negative symptoms, according to the following recommendations of Consensus Development Conference Attendees. In our study, we evaluated in an open-label study the efficacy of some second-generation antipsychotics (clozapine, quetiapine, olanzapine, aripiprazole, paliperidone) in 42 patients with schizophrenia or schizoaffective disorder (DSM-5 criteria) with 'persistent negative symptoms'. We used different rating scales (PANSS, CDSs, BNSS, BPRS), but mainly we focused on the new Brief Negative Symptoms Scale (BNSS) for negative symptoms. Our total data indicate an overall statistically significant reduction in all scales, although not clinically relevant.