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LB-102

Schizophrenia

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345 sources

Product information and disease descriptionPlace of product in therapyDisease description

Clinical presentation - signs and symptoms

11 evidence topics · 18 sources

Positive symptoms: delusions, hallucinations, and disorganized thought

“Delusions (fixed false beliefs) may be present and bizarre (extremely implausible). Thought broadcasting, thought insertion, or withdrawal may also be reported.” (opens the source at this quote in a new tab)

“Hallucinations, mainly auditory, are common but may be in any sensory modality. Patients may report hearing voices commenting on their actions or conversing with each other.” (opens the source at this quote in a new tab)

“Thought processes (inferred from the patient's speech) may be disorganized, leading to illogical connections, loose associations, or thought blocking when the patient suddenly stops speaking mid-sentence.” (opens the source at this quote in a new tab)

“Symptoms of schizophrenia include psychotic symptoms such as hallucinations, delusions, and thought disorder (unusual ways of thinking), as well as reduced expression of emotions, reduced motivation to accomplish goals, difficulty in social relationships, motor impairment, and cognitive impairment.” (opens the source at this quote in a new tab)

Negative symptoms: blunted affect, alogia, avolition, asociality, and anhedonia

“The negative symptom domain consists of five key constructs: blunted affect, alogia (reduction in quantity of words spoken), avolition (reduced goal-directed activity due to decreased motivation), asociality, and anhedonia (reduced experience of pleasure). Negative symptoms are common in schizophrenia; up to 60% of patients may have prominent clinically relevant negative symptoms that require treatment.” (opens the source at this quote in a new tab)

“Negative symptoms can be primary symptoms, which are intrinsic to the underlying pathophysiology of schizophrenia, or secondary symptoms that are related to psychiatric or medical comorbidities, adverse effects of treatment, or environmental factors.” (opens the source at this quote in a new tab)

“Several studies have shown that negative symptoms might be primary to schizophrenia or secondary to other factors, and that they cluster in the domains of avolition-apathy and expressive deficit.” (opens the source at this quote in a new tab)

Negative symptoms: prevalence of any and of primary negative symptoms in treated outpatients

“A total of 1,452 evaluable patients (863 men, 60.9%), 40.7 +/- 12.2 (mean +/- SD) years of age, were included. One or more negative symptoms were present in 57.6% of patients, with primary negative symptoms in 12.9% of subjects. The most frequent negative symptom items were social withdrawal (45.8%), emotional withdrawal (39.1%), poor rapport (35.8%), and blunted affect (33.1%).” (opens the source at this quote in a new tab)

Cognitive impairment: magnitude relative to healthy controls

“Individuals with schizophrenia show a substantial impairment in overall cognitive performance, which, on average, is around two standard deviations below that in healthy controls” (opens the source at this quote in a new tab)

“Moreover, this deficit contributes to poor clinical outcomes such as unemployment and an inability to live independently” (opens the source at this quote in a new tab)

“Moderate to large raw effect sizes (d > .60) were obtained for all 22 neurocognitive test variables, and none of the associated confidence intervals included zero.” (opens the source at this quote in a new tab)

“Results evidence that in all domains and in all different analyses performed within each domain, patients show a significant reduction of cognitive efficiency with respect to normal subjects.” (opens the source at this quote in a new tab)

Cognitive impairment: first-episode schizophrenia

“The meta-analysis uses 43 separate samples of 2,204 FE patients with a mean age of 25.5 and 2,775 largely age- and gender-matched control participants. FE samples demonstrated medium-to-large impairments across 10 neurocognitive domains (mean effect sizes from -0.64 to -1.20).” (opens the source at this quote in a new tab)

Mood symptoms: comorbid depression

“Of the 5633 potentially eligible studies identified, 18 studies (n = 6140 SZ stabilized outpatients) were retrieved in the systematic review and included in the meta-analysis. The pooled estimate of the prevalence of SZ-MDD was 32.6% (95% CI: 27.9–37.6)” (opens the source at this quote in a new tab)

“Among adults with SSDs, the most common comorbidities were major depressive episode (51.7%, CI 34.0–69.4), alcohol use disorder (23.0%, CI 2.6–43.3), cannabis use disorder (20.0%, CI 1.2–38.7) and post-traumatic stress disorder (17.3%, CI 4.7–30.0).” (opens the source at this quote in a new tab)

Suicidality: suicidal ideation and suicide plans

“Twenty-six studies covering 5079 people with schizophrenia were included for meta-analysis. The lifetime and point prevalence of SI were 34.5% (95% CI: 28.2−40.9%), and 29.9% (95% CI: 24.2−35.6%), respectively. The lifetime prevalence of SP was 44.3% and the point prevalence of SP ranged between 6.4 and 13%.” (opens the source at this quote in a new tab)

“Suicide is the most common cause of premature death in schizophrenia, with two-thirds of patients reporting at least one episode of suicidal ideation.” (opens the source at this quote in a new tab)

Acute exacerbation: return of psychotic symptoms at relapse

“once illness recurrence occurs symptoms rapidly return to levels similar to the initial psychotic episode” (opens the source at this quote in a new tab)

“The analysis included 167 double-blind randomized controlled trials with 28,102 mainly chronic participants.” (opens the source at this quote in a new tab)

“Positive symptoms (SMD 0.45) improved more than negative symptoms (SMD 0.35) and depression (SMD 0.27).” (opens the source at this quote in a new tab)

Agitation: frequency in psychiatric emergency settings

“Agitation is a common problem in many patients with schizophrenia, bipolar mania, or dementia.” (opens the source at this quote in a new tab)

“The reported prevalence of agitation in psychiatric emergency services is between 4–10%” (opens the source at this quote in a new tab)

“A total of 334 agitation episodes out of 7295 psychiatric emergencies were recorded, giving a prevalence rate of 4.6% (95% CI: 4.12-5.08).” (opens the source at this quote in a new tab)

“The most common psychiatric conditions associated with agitation were schizophrenia, bipolar disorder and personality disorder.” (opens the source at this quote in a new tab)

Agitation: episodes reported by people with schizophrenia or bipolar disorder

“Patients experienced an average of 22.4 (SD 57.2) mild, 15.4 (SD 61.2) moderate, 6.8 (SD 63.3) moderate-intense and 2.9 (SD 24.4) severe episodes within the last 12 months; on average 2.7 (SD 6.8) required hospital attendance.” (opens the source at this quote in a new tab)

Psychomotor and behavioral signs on examination

“Behavior may range from psychomotor retardation to agitation, and patient responses can vary from being cooperative to being unpredictable, withdrawn, or hostile.” (opens the source at this quote in a new tab)

“Some patients may exhibit grossly disorganized or abnormal motor behavior, including catatonic behaviors, such as stupor, mutism, odd gestures, or posturing.” (opens the source at this quote in a new tab)

Proportion of people with schizophrenia who experience agitation during an acute exacerbation

No evidence found.