Abstract：
BACKGROUND: Recent operational criteria for treatment-resistant schizophrenia (TRS) recognized positive and negative symptoms. TRS patients may have heterogeneity in negative symptoms, but empirical data were lacking. We aimed to characterize TRS patients based on negative symptoms using cluster analysis, and to examine between-cluster differences in social functioning.
METHODS: We administered the Clinical Assessment Interview of Negative symptoms (CAINS), Brief Negative Symptom Scale (BNSS), the Positive and Negative Syndrome Scale (PANSS) and the Social and Occupational Functional Assessment (SOFAS to 126 TRS outpatients. All patients also completed the Temporal Experience of Pleasure Scale (TEPS), the Emotion Expressivity Scale (EES), and the Social Functional Scale (SFS). A two-stage hierarchical cluster analysis was performed with the CAINS, TEPS and EES as clustering variables. We validated the clusters using ANOVAs to compare group differences in the BNSS, PANSS, SOFAS and SFS.
RESULTS: Clustering indices supported a 3-cluster solution. Clusters 1 (n = 46) and 3 (n = 16) exhibited higher CAINS scores than Cluster 2 (n = 64), and were negative-symptom TRS subtypes. Cluster 1 reported lower TEPS than Cluster 3; but Cluster 3 reported lower EES than Cluster 1. Upon validation, Clusters 1 and 3 exhibited higher BNSS scores than Cluster 2, but only Cluster 1 exhibited lower SOFAS and higher PANSS general symptoms than Cluster 2. Both Clusters 1 and 3 had higher self-report functioning than Cluster 2.
CONCLUSIONS: We provided evidence for heterogeneity of negative symptoms in TRS. Negative symptoms can characterize TRS patients and predict functional outcome.
METHODS: We administered the Clinical Assessment Interview of Negative symptoms (CAINS), Brief Negative Symptom Scale (BNSS), the Positive and Negative Syndrome Scale (PANSS) and the Social and Occupational Functional Assessment (SOFAS to 126 TRS outpatients. All patients also completed the Temporal Experience of Pleasure Scale (TEPS), the Emotion Expressivity Scale (EES), and the Social Functional Scale (SFS). A two-stage hierarchical cluster analysis was performed with the CAINS, TEPS and EES as clustering variables. We validated the clusters using ANOVAs to compare group differences in the BNSS, PANSS, SOFAS and SFS.
RESULTS: Clustering indices supported a 3-cluster solution. Clusters 1 (n = 46) and 3 (n = 16) exhibited higher CAINS scores than Cluster 2 (n = 64), and were negative-symptom TRS subtypes. Cluster 1 reported lower TEPS than Cluster 3; but Cluster 3 reported lower EES than Cluster 1. Upon validation, Clusters 1 and 3 exhibited higher BNSS scores than Cluster 2, but only Cluster 1 exhibited lower SOFAS and higher PANSS general symptoms than Cluster 2. Both Clusters 1 and 3 had higher self-report functioning than Cluster 2.
CONCLUSIONS: We provided evidence for heterogeneity of negative symptoms in TRS. Negative symptoms can characterize TRS patients and predict functional outcome.
摘要：
背景：最近的难治性精神分裂症（TRS）的操作标准识别为阳性和阴性症状。TRS患者阴性症状可能存在异质性，但缺乏经验数据。我们的目标是使用聚类分析根据阴性症状来表征TRS患者，并检查集群之间的社会功能差异。
方法：我们进行了阴性症状临床评估访谈（CAINS），简短阴性症状量表（BNSS），阳性和阴性综合征量表（PANSS）以及社会和职业功能评估（SOFAS对126名TRS门诊患者。所有患者还完成了快乐时间体验量表（TEPS），情感表现力量表(EES)，和社会功能量表(SFS)。对CAINS进行了两阶段层次聚类分析，TEPS和EES作为聚类变量。我们使用ANOVA验证了聚类，以比较BNSS中的组差异，PANSS,SOFAS和SFS。
结果：集群索引支持3集群解决方案。群集1（n=46）和3（n=16）表现出比群集2（n=64）更高的CAINS得分，并且是阴性症状TRS亚型。群集1报告的TEPS低于群集3；但群集3报告的EES低于群集1。验证后，聚类1和3表现出比聚类2更高的BNSS评分,但只有聚类1表现出比聚类2更低的SOFAS和更高的PANSS一般症状。群集1和群集3的自我报告功能均高于群集2。
结论：我们提供了TRS阴性症状异质性的证据。阴性症状可以表征TRS患者并预测功能结果。
方法：我们进行了阴性症状临床评估访谈（CAINS），简短阴性症状量表（BNSS），阳性和阴性综合征量表（PANSS）以及社会和职业功能评估（SOFAS对126名TRS门诊患者。所有患者还完成了快乐时间体验量表（TEPS），情感表现力量表(EES)，和社会功能量表(SFS)。对CAINS进行了两阶段层次聚类分析，TEPS和EES作为聚类变量。我们使用ANOVA验证了聚类，以比较BNSS中的组差异，PANSS,SOFAS和SFS。
结果：集群索引支持3集群解决方案。群集1（n=46）和3（n=16）表现出比群集2（n=64）更高的CAINS得分，并且是阴性症状TRS亚型。群集1报告的TEPS低于群集3；但群集3报告的EES低于群集1。验证后，聚类1和3表现出比聚类2更高的BNSS评分,但只有聚类1表现出比聚类2更低的SOFAS和更高的PANSS一般症状。群集1和群集3的自我报告功能均高于群集2。
结论：我们提供了TRS阴性症状异质性的证据。阴性症状可以表征TRS患者并预测功能结果。
