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Predominant negative symptoms in female schizophrenia in-patients: An observational study

Published online by Cambridge University Press:  26 August 2025

J. Dragasek
Affiliation:
University of P. J. Safarik, Kosice, Slovakia
Z. B. Dombi*
Affiliation:
Gedeon Richter Plc., Budapest, Hungary
P. Herman
Affiliation:
Gedeon Richter Plc., Budapest, Hungary
V. Dzurilla
Affiliation:
Gedeon Richter Slovakia, Bratislava, Slovakia
Á. Barabássy
Affiliation:
Gedeon Richter Plc., Budapest, Hungary
*
*Corresponding author.

Abstract

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Introduction

Negative symptoms are a key aspect of schizophrenia, significantly impacting a patient’s functioning and quality of life. Although hospitalizations are often associated with positive symptoms, negative symptoms can also dominate the clinical picture in in-patients. Female patients are usually underrepresented in schizophrenia studies.

Objectives

To analyse the changes of negative symptoms in female in-patients.

Methods

This was an observational study with data recorded at hospital entry and release. Adult inpatients with a schizophrenia diagnosis according to the International Classification of Diseases 10th edition who exhibited predominant negative symptoms according to clinical judgement were included. Patients received pharmacological and some non-pharmacological treatment as usual.

The primary outcome measure was the modified Short Assessment of Negative Domains (m-SAND), an anamnesis-based scale that is composed of 7 items: two positive items (delusions and hallucinations) and five negative items (anhedonia, alogia, avolition, asociality and affective flattening). Each item is rated from 0 to 5 (not observed; mild; moderate; moderately severe; severe; and extreme). Other measurements included the Self-evaluation of Negative Symptoms (SNS).

Least squares (LS) means were calculated for the change from baseline to final visit using a mixed model for repeated measures (MMRM).

Results

63 female patients were included in the study. The mean age was 41.6 years with 14.2 years of mean duration of illness. All patients had predominant negative symptoms, in fact, 65% of them was hospitalized because of it. 30% of the patients also had secondary negative symptoms, mainly due to positive symptoms. The mean duration of hospital stay was 38 days. All patients received pharmacotherapy. At baseline, 9.5% were on cariprazine monotherapy and 84.1% on cariprazine combined with another antipsychotic such as olanzapine (23.8%) or quetiapine (7.9%). By the end of the hospital stay, 14.3% of female patients received cariprazine monotherapy and 82.5% cariprazine combination treatment with olanzapine (30.2%) or clozapine (15.9%). Significant decrease was detected in m-SNAD total score (LS mean change from baseline: -10.95) and SNS total score (LS mean change from baseline: -9.74). Functioning increased from poor (76%) to ‘manifest disabilities’ according to PSP (81%).

Conclusions

In summary, female patients had significant improvement during their hospital stay in terms of negative symptoms. The most utilized pharmacotherapy during the hospital stay was cariprazine both in a form of mono- and polytherapy.

Disclosure of Interest

J. Dragasek: None Declared, Z. Dombi Employee of: I am an employee of Gedeon Richter Plc., originator of cariprazine., P. Herman Employee of: I am an employee of Gedeon Richter Plc., originator of cariprazine., V. Dzurilla Employee of: I am an employee of Gedeon Richter Plc., originator of cariprazine., Á. Barabássy Employee of: I am an employee of Gedeon Richter Plc., originator of cariprazine.

Information

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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