Persistent negative symptoms in first episode patients with schizophrenia: results from the European First Episode Schizophrenia Trial

Eur Neuropsychopharmacol. 2013 Mar;23(3):196-204. doi: 10.1016/j.euroneuro.2012.04.019. Epub 2012 May 28.


Negative symptoms that do not improve following antipsychotic treatment represent a challenge for development of effective treatments. Few studies have been carried out so far, especially in first-episode schizophrenia patients, to clarify prevalence, correlates and impact of persistent negative symptoms (PNS) on short- and long-term outcome of the disease. All patients from EUFEST study for whom both baseline and 12-month assessments were available were included (N=345). PNS were defined as the presence of at least one negative symptom of moderate or higher severity, not confounded by depression or parkinsonism, at baseline and after 1 year of treatment. Patients with PNS were compared to those with at least one negative symptom of moderate or higher severity at the baseline, not persisting after 1 year, on demographic, clinical, neurocognitive, global functioning and quality of life measures. PNS not confounded by depression or parkinsonism were present in 6.7% of the sample. The symptom that more often persisted was blunted affect. Patients with PNS differed from those without PNS for a longer duration of untreated psychosis (DUP) and a more frequent discontinuation of study treatment; they also had a poorer psychopathological outcome and a worse global functioning after 1 year of treatment. The presence of PNS was associated to poorer improvement of all psychopathological dimensions and worse global functioning after 1 year of treatment. The longer DUP in subjects with PNS suggests that programs aimed at shortening DUP might reduce the prevalence of PNS and improve prognosis of schizophrenia.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Amisulpride
  • Antipsychotic Agents / therapeutic use*
  • Benzodiazepines / therapeutic use
  • Cognition Disorders / psychology
  • Dibenzothiazepines / therapeutic use
  • Female
  • Haloperidol / therapeutic use
  • Humans
  • Male
  • Neuropsychological Tests
  • Olanzapine
  • Piperazines / therapeutic use
  • Psychomotor Disorders / psychology
  • Psychotic Disorders / drug therapy*
  • Psychotic Disorders / psychology
  • Quetiapine Fumarate
  • Schizophrenia / drug therapy*
  • Schizophrenic Psychology*
  • Sulpiride / analogs & derivatives
  • Sulpiride / therapeutic use
  • Thiazoles / therapeutic use
  • Treatment Outcome
  • Young Adult


  • Antipsychotic Agents
  • Dibenzothiazepines
  • Piperazines
  • Thiazoles
  • Benzodiazepines
  • Quetiapine Fumarate
  • ziprasidone
  • Sulpiride
  • Amisulpride
  • Haloperidol
  • Olanzapine