Prevalence,Sociodemographic,and Clinical Correlates of Older Chinese Patients With Deficit Schizophrenia

Abstract

Objective:

No study has investigated the frequency and risk factors for deficit schizophrenia (DS) in Chinese Han population. We investigated the prevalence of DS among community-dwelling older Chinese patients with schizophrenia and examined the sociodemographic and clinical correlates of DS in this population.

Methods:

A total of 326 community-dwelling older patients with schizophrenia were recruited in this cross-sectional study. Deficit schizophrenia was confirmed using the Chinese version of the Schedule for the Deficit Syndrome. Data pertaining to sociodemographic and clinical characteristics were collected. Psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS).

Results:

The prevalence of DS in the study population was 26.7% (31.2% among male patients and 21.6% among female patients with schizophrenia). Patients with DS had significantly higher current smoking rate, hospitalizations, PANSS negative score, PANSS total score, and had earlier age at onset than patients with non-deficit schizophrenia (N-DS). The N-DS patients had higher PANSS positive scores and a greater proportion of married patients. Multiple logistic regression analysis indicated that negative PANSS score (odds ratio [OR] = 1.10, 95% confidence interval [CI] = 1.04-1.16, P < .001), male sex (OR = 1.71, 95% CI = 1.53-1.91, P = .037), age at onset (OR = 0.88, 95% CI = 0.82-0.94, P = .035), and current smoking (OR = 1.37, 95% CI = 1.15-1.63, P = .041) were independently associated with DS.

Conclusion:

Deficit schizophrenia is relatively common among older community-dwelling Chinese patients with schizophrenia. High negative symptom scores, male sex, early onset, and smoking were independent correlates for DS.

Keywords

prevalence older deficit schizophrenia

Get full access to this article

View all access options for this article.

References

Kirkpatrick

Buchanan

Ross

Carpenter

Jr . A separate disease within the syndrome of schizophrenia. Arch Gen Psychiatry. 2001;58(2):165–171.

Dai

Tang

, et al. Convergence and divergence of brain network dysfunction in deficit and non-deficit schizophrenia. Schizophr Bull. 2017;43(6):1315–1328.

Buchanan

. Persistent negative symptoms in schizophrenia: an overview. Schizophr Bull. 2007;33(4):1013–1022.

Ahmed

Strauss

Buchanan

Kirkpatrick

Carpenter

. Are negative symptoms dimensional or categorical? Detection and validation of deficit schizophrenia with taxometric and latent variable mixture models. Schizophr Bull. 2015;41(4):879–891.

Galderisi

Bucci

Mucci

, et al. Categorical and dimensional approaches to negative symptoms of schizophrenia: focus on long-term stability and functional outcome. Schizophr Res. 2013;147(1):157–162.

Tripathi

Kar

Shukla

Cognitive deficits in schizophrenia: understanding the biological correlates and remediation strategies. Clin Psychopharmacol Neurosci. 2018;16(1):7–17.

Dantas

Barros

Banzato

Fernandes

. Deficit and nondeficit schizophrenia: boundaries in question. Schizophr Res. 2011;130(1-3):289–290.

Kallel

Brunelin

Zghal

, et al. Summer birth and deficit schizophrenia in Tunisia. Psychiatry Res. 2007;152(2-3):273–275.

Cohen

Brown

Minor

. The psychiatric symptomatology of deficit schizophrenia: a meta-analysis. Schizophr Res. 2010;118(1-3):122–127.

10.

Mete

Sarıkaya

Erol

The relationship of deficit syndrome with clinical symptoms, summer births and heritability in patients with schizophrenia. Turk Psikiyatri Derg. 2015;26(4):229–235.

11.

Arango

Bobes

Kirkpatrick

Garcia-Garcia

Rejas

. Psychopathology, coronary heart disease and metabolic syndrome in schizophrenia spectrum patients with deficit versus non-deficit schizophrenia: findings from the CLAMORS study. Eur Neuropsychopharmacol. 2011;21(12):867–875.

12.

Kirkpatrick

Ross

Walsh

Karkowski

Kendler

. Family characteristics of deficit and nondeficit schizophrenia in the Roscommon Family Study. Schizophr Res. 2000;45(1-2):57–64.

13.

Lahti

Holcomb

Medoff

Weiler

Tamminga

Carpenter

Jr . Abnormal patterns of regional cerebral blood flow in schizophrenia with primary negative symptoms during an effortful auditory recognition task. Am J Psychiatry. 2001;158(11):1797–1808.

14.

Kou

, et al. Association of catechol-O-methyltransferase gene polymorphisms with schizophrenia and negative symptoms in a Chinese population. Am J Med Genet B Neuropsychiatr Genet. 2012;159B(4):370–375.

15.

Pelayo-Terán

Pérez-Iglesias

Vázquez-Bourgon

, et al. Catechol-O-methyltransferase Val158Met polymorphism and negative symptoms after acute antipsychotic treatment in first-episode non-affective psychosis. Psychiatry Res. 2011;185 (1-2):286–289.

16.

Xiang

Wong

Tsoh

, et al. Quality of life in older patients with chronic obstructive pulmonary disease (COPD) in Hong Kong: a case-control study. Perspect Psychiatr Care, 2014;51(2):319–324.

17.

Tandon

Gaebel

Barch

, et al. Definition and description of schizophrenia in the DSM-5. Schizophr Res. 2013;150(1):3–10.

18.

Wang

, et al. Management and services for psychosis in People’s Republic of China in 2015. Chin J Psychiatry. 2017;50(4):302–305.

19.

Tang

Wang

, et al. Neurocognitive impairments in deficit and non-deficit schizophrenia and their relationships with symptom dimensions and other clinical variables. PLoS One. 2015;10(9):e0138357.

20.

Miller

Vandome

Mcbrewster

, et al. Positive and Negative Syndrome Scale[M]. Rapid, SD: Alphascript Publishing; 2011.

21.

Liu

Chen

Shao

, et al. Prevalence and correlated factors of deficit schizophrenia in Chinese community-dwelling patients with schizophrenia. Chin J Behav Med Brain Sci. 2018;27(10):915–919.

22.

López-Díaz

Lara

Lahera

. Is the prevalence of the deficit syndrome in schizophrenia higher than estimated? Results of a meta-analysis. Psychiatry Investig. 2018;15(1):94–98.

23.

Roy

Maziade

Labbé

Mérette

. Male gender is associated with deficit schizophrenia: a meta-analysis. Schizophr Res. 2001;47(2-3):141–147.

24.

Gogos

Sbisa

A M

Sun

, et al. A role for estrogen in schizophrenia: clinical and preclinical findings. Int J Endocrinol. 2015;2015(4, article 39):615356.

25.

Sham

Jones

Russell

, et al. Age at onset, sex, and familial psychiatric morbidity in schizophrenia. camberwell collaborative psychosis study. Br J Psychiatry. 1994;165(4):466–473.

26.

Rapoport

Addington

Frangou

Psych

. The neurodevelopmental model of schizophrenia: update 2005. Mol Psychiatry. 2005;7(2):434–449.

27.

Zhang

Liang

Chen

, et al. Cigarette smoking in male patients with chronic schizophrenia in a Chinese population: prevalence and relationship to clinical phenotypes. PLoS One. 2012;7(2):e30937.

28.

Cao

Zhong

, et al. Smoking in male patients with schizophrenia in China: a meta-analysis. Drug Alcohol Depend. 2016;162:146–153.

29.

Kotov

Lin

Bromet

Schwartz

. Smoking in schizophrenia: diagnostic specificity, symptom correlates, and illness severity. Schizophr Bull. 2010;36(1):173–181.

30.

Tang

George

Mao

Cai

Chen

. Cigarette smoking in Chinese male inpatients with schizophrenia: a cross-sectional analysis. J Psychiatr Res. 2007;41(1-2):43–48.

31.

Wheeler

Wessa

Szeszko

, et al. Further neuroimaging evidence for the deficit subtype of schizophrenia: a cortical connectomics analysis. JAMA Psychiatry. 2015;72(5):446–455.

32.

Kopelowicz

Zarate

Tripodis

Gonzalez

Mintz

. Differential efficacy of olanzapine for deficit and nondeficit negative symptoms in schizophrenia. Am J Psychiatry. 2000;157(6):987–993.

33.

Neumann

Grimes

Walker

Baum

. Developmental pathways to schizophrenia: behavioral subtypes. J Abnorm Psychol. 1995;104 (4):558–566.

34.

Strauss

Allen

Miski

Buchanan

Kirkpatrick

Carpenter

Jr . Differential patterns of premorbid social and academic deterioration in deficit and nondeficit schizophrenia. Schizophr Res. 2012;135(1-3):134–138.

35.

Voineskos

Foussias

Lerch

, et al. Neuroimaging evidence for the deficit subtype of schizophrenia. JAMA Psychiatry. 2013;70(5):472–480.