Deficit symptoms in schizophrenia - mechanisms, assessment, and therapeutic interventions

Abstract

Schizophrenia is a complex neuropsychiatric disorder with severe functional impact. Deficit symptoms, such as affective flattening, anhedonia, and avolition, profoundly affect patients' quality of life and respond poorly to standard treatments, requiring increased attention in clinical management. The study examines negative symptoms in schizophrenia: neurobiological mechanisms, assessment, and treatment options, highlighting their impact on patients' functioning and prognosis. The study examines assessment tools for negative symptoms (PANSS, SANS, NSA-16, BNSS, CAINS), the efficacy of atypical antipsychotics, adjuvant treatments (antidepressants, modafinil), and psychosocial interventions (cognitive-behavioral therapy, cognitive remediation), based on clinical guidelines and recent studies. Negative symptoms have a complex neurobiological basis, involving fronto-striatal dysfunction and structural abnormalities in frontal and temporal regions. Conventional antipsychotics show limited efficacy, but cariprazine has proven superior to risperidone in alleviating persistent negative symptoms. Adjuvant treatments (antidepressants, glutamatergic agonists) may provide moderate but inconsistent benefits. Psychosocial interventions (cognitive-behavioral therapy, social skills training), combined with pharmacotherapy, improve social functioning, motivation, and quality of life, reducing the overall disease burden. Negative symptoms - a major therapeutic challenge in schizophrenia. An integrated approach combining pharmacotherapy with personalized psychosocial interventions can improve functioning and quality of life. Family involvement and continuous monitoring are essential. Better therapies are needed.