Recommendations for the treatment of schizophrenia with negative symptoms. Standards of pharmacotherapy by the Polish Psychiatric Association (Polskie Towarzystwo Psychiatryczne), part 1.Psychiatr Pol 2019; 53(3):497-524PP
Schizophrenia is a chronic illness that in the majority of cases begins either in adolescence or early adulthood. It is often perceived as a severe, incurable condition with generally poor prognosis, while patients suffering from it tend to be agitated, aggressive and unpredictable in their behaviors. Growing awareness, along with gradual changes in the approach to the need for multifaceted schizophrenia therapy, as well as considerable progress in pharmacotherapy in recent years have allowed for improving the prognosis for many patients. Because of polymorphic character of the condition, many schizophrenia sub-types are identified by means of classifications of mental disorders, adjusting the criteria and descriptions to most frequently observed clinical scenarios. Clinical descriptions of schizophrenia are based on various psychopathological models, which are often multidimensional and multifactorial. They virtually always take account of the following two dimensions: negative (deficit) and positive (creative) symptoms. Contemporary approach to schizophrenia treatment assumes multidirectional therapeutic intervention aimed at achieving full remission and the patient's return to full psychosocial functioning. Long-term studies indicate that the severity of negative symptoms is the prognostic indicator of the deterioration of social and professional functioning and reduced quality of life. The following paper presents the review of concepts and research devoted to negative symptoms in schizophrenia and their treatment; in the second part, international standards and recommendations of the Polish Psychiatric Association concerning the approach to effective management of negative symptoms in schizophrenia are discussed.