A Comparative analysis of Negative symptoms in Remission phase of Schizophrenia and Bipolar Affective Disorder

BACKGROUND: Negative symptoms are characterized by a reduction of normal functions. They have been appreciated as core features of schizophrenia but remain under-recognized and poorly treated. They include – affective flattening, alogia, avolition, apathy, anhedonia, asociality, and impairment of attention. Initially thought to be specific to schizophrenia, they are also seen in other disorders – schizoaffective disorder, neuropsychiatric disorders, and bipolar affective disorder. AIMS: To assess various negative symptoms in Schizophrenia and Bipolar affective disorder patients in remission. METHODS: 100 patients in symptomatic remission were included in this cross sectional study. Remission was assessed using the Clinical Global Impression Scale (CGI). The Scale for assessment of Negative Symptoms (SANS) was used to evaluate negative symptoms. RESULTS: Negative symptoms were present in 84% of patients in the schizophrenia group and 56% in the bipolar affective disorder group. The overall negative symptom frequency and severity was higher in the schizophrenia group. The mean SANS summary score was 7.38±4.46 in the schizophrenia group, which was higher than the BPAD group(4.80±2.69) and the difference was statistically significant (p=0.005). Affective flattening, alogia, and attentional impairment were significantly impaired in patients with Schizophrenia. Although mean scores were higher on the Anhedonia and avolition domains, the difference was statistically insignificant. CONCLUSION: Residual negative symptoms are frequently present in bipolar disorder and schizophrenia patients in remission and need to be addressed as important treatment goals for better functional recovery and outcome.