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Schizophrenia Bulletin 2000 26(3):737-744;
© 2000 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
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© Oxford University Press

Distress Attributed to Negative Symptoms in Schizophrenia

Jean-Paul Selten, M.D., Ph.D., Durk Wiersma, Ph.D. and Robert J. van den Bosch, M.D., Ph.D.
Associate Professor, Department of Psychiatry, University of Utrecht Utrecht, The Netherlands
Sociologist and Associate Professor, Department of Social PsychiatryUniversity of Groningen Groningen, The Netherlands
Professor of Psychiatry, University of Groningen, Groningen, The Netherlands

Send reprint requests to Dr. J.-P. Selten, Dept. of Psychiatry, University Hospital, Reference nr B01.206, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands; e-mail: j.p.selten{at}psych.azu.nl

The purpose of the study was to examine (1) to which negative symptoms schizophrenia patients attribute distress and (2) whether clinical variables can predict the levels of reported distress. With the help of a research assistant, 86 hospitalized patients completed a self-rating scale for negative symptoms. The 21 items of the self-rating scale were taken from the Scale for the Assessment of Negative Symptoms (SANS). A psychiatrist rated the patients on a number of scales, including the SANS. When patients reported particular symptoms, they were asked whether those symptoms bothered or distressed them. Answers to this question were highly dependent on the type of symptom involved. Distress was most often attributed to symptoms in the subscale avolition-apathy. Patients were also asked how much they were bothered or distressed. Again, high levels of distress were most often attributed to items in the subscale avolition-apathy. A summary score was developed for the level of reported distress: the distress score. Regression analysis showed that distress scores were not associated with the observed severity of negative symptoms or with the level of psychiatric disability. High distress scores were best predicted by the combination of high scores for depression and high scores for insight into positive symptomatology. However, this model explained only a quarter of the variance in distress scores.

Keywords: Schizophrenia / negative symptoms / awareness / phenomenology / neuropsychology / rehabilitation


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