A novel research tool developed by researchers from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London has identified a link between the negative symptoms experienced by people with schizophrenia and adverse clinical outcomes.
Negative symptoms can include poor motivation, poor eye contact and a reduction in speech and activity. As a result, people with schizophrenia often appear emotionless, flat and apathetic. These contrast with positive symptoms - psychotic behaviours not seen in healthy people, such as delusions or hallucinations.
Published today in BMJ Open, the study is the largest- ever to investigate a relationship between negative symptoms and clinical outcomes, drawing from a sample of more than 7,500 patients.
Researchers used the Clinical Record Interactive Search (CRIS) application, a text-mining tool, to analyse anonymised patient data on negative symptoms from the South London and Maudsley NHS Foundation Trust (SLaM) Biomedical Research Centre (BRC) Case Register.
schizophrenia linked to poor clinical outcomes" align="right" /> Natural Language Processing (NLP) was used to detect statements within the clinical records which determined references to specified negative symptoms. 10 negative symptoms were identified, including poor motivation, blunted or flattened mood, poor eye contact, emotional withdrawal, poor rapport, social withdrawal, poverty of speech (excessively short speech with minimal elaborations), inability to speak, apathy and concrete thinking (the inability to think in abstract terms).
They found that 41 per cent of patients showed the presence of two or more negative symptoms. Negative symptoms across the sample were associated with an increased likelihood of hospital admission, longer duration of admission and an increased likelihood of re-admission following discharge from hospital.
The most frequently recorded negative symptoms were poor motivation (31 per cent), blunted or flattened mood (27 per cent), poor eye contact (26 per cent) and emotional withdrawal (24 per cent).
Dr Rashmi Patel from the Department of Psychosis Studies at the IoPPN, said: ‘Hospital admissions are the main drivers of cost in the care of patients with schizophrenia - yet they have traditionally been linked to the severity of positive psychotic symptoms.
‘Our data indicate that negative symptoms are an equally important factor, and suggest that a greater emphasis on assessing and treating these features of schizophrenia may have significant health economic benefits.
‘However, as our findings are drawn from observational data, interventional clinical studies are required to determine whether an effective treatment for negative symptoms would lead to better clinical outcomes.’
This research was funded by the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust (SLaM) and King’s College London.
About King’s College London:
King’s College London is one of the top 20 universities in the world (2014/15 QS World University Rankings) and among the oldest in England. King’s has more than 26,500 students (of whom nearly 10,400 are graduate students) from some 150 countries worldwide, and nearly 6,900 staff. The university is in the second phase of a £1 billion redevelopment programme which is transforming its estate.
King’s has an outstanding reputation for world-class teaching and cutting-edge research. In the 2014 Research Excellence Framework (REF) King’s was ranked 6th nationally in the ‘power’ranking, which takes into account both the quality and quantity of research activity, and 7th for quality according to Times Higher Education rankings. Eighty-four per cent of research at King’s was deemed ‘world-leading’or ‘internationally excellent’(3* and 4*). The university is in the top seven UK universities for research earnings and has an overall annual income of more than £600 million.
King’s has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine, nursing and dentistry) and social sciences including international affairs. It has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA and research that led to the development of radio, television, mobile phones and radar.
King’s College London and Guy’s and St Thomas’, King’s College Hospital and South London and Maudsley NHS Foundation Trusts are part of King’s Health Partners. King’s Health Partners Academic Health Sciences Centre (AHSC) is a pioneering global collaboration between one of the world’s leading research-led universities and three of London’s most successful NHS Foundation Trusts, including leading teaching hospitals and comprehensive mental health services.
King’s fundraising campaign -World questions|King’s answers -created to address some of the most pressing challenges facing humanity has reached its £500 million target 18 months ahead of schedule. The university is now aiming to build on this success and raise a further £100 million by the end of 2015, to fund vital research, deliver innovative new treatments and to support scholarships. The campaign’s five priority areas are neuroscience and mental health, leadership and society, cancer, global power and children’s health.
KING’S COLLEGE LONDON