Negative symptoms in patients with major depressive disorder: a preliminary report.

I I Galynker, L J Cohen, J Cai
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Abstract

Objective: The purpose of this study was to examine negative symptoms (NSs) in patients with major depressive disorder (MDD) and their relation to depressive symptoms (DSs) and other psychiatric symptoms.

Background: Features similar to NSs were previously described in patients with depression.

Method: The Hamilton Rating Scale for Depression (HRSD), Positive and Negative Symptom Scale (PANSS), Scale for the Assessment of Negative Symptoms (SANS), and Mini-Mental State Examination were administered to 23 patients with MDD and 10 normal control subjects.

Results: As expected, the mean scores of the HRSD, SANS, and negative symptom subscale of the PANSS of the patients with MDD were significantly higher than those of control subjects, validating the clinical significance of NSs as well as DSs in MDD patients. Within the MDD group, although measures of NSs were intercorrelated, there were no other correlations between the measures. Thus, measures of NSs and DSs were not intercorrelated. When the HRSD was divided in two subscales, HRSD negative symptom subscale scores but not HRSD depressive symptom subscale scores were correlated with PANSS negative symptom subscale and SANS total scores as well as with scores on the affective flattening subscale.

Conclusions: These results suggest a high level of NSs in patients with MDD, which are distinct from positive symptoms of depression and may constitute a distinct dimension. Negative symptoms and DSs in MDD may represent separate constructs. Further, the HRSD might have possible subscales in MDD as it does in schizophrenia.

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重度抑郁症患者的阴性症状:初步报告
目的:探讨重度抑郁障碍(MDD)患者的阴性症状(NSs)及其与抑郁症状(DSs)和其他精神症状的关系。背景:与NSs相似的特征先前在抑郁症患者中被描述过。方法:采用汉密尔顿抑郁评定量表(HRSD)、阳性和阴性症状评定量表(PANSS)、阴性症状评定量表(SANS)和简易精神状态检查量表对23例重度抑郁症患者和10例正常对照进行分析。结果:MDD患者的HRSD、SANS和PANSS阴性症状亚量表的平均得分与预期一样显著高于对照组,验证了NSs和DSs在MDD患者中的临床意义。在MDD组中,虽然NSs的测量是相互关联的,但测量之间没有其他相关性。因此,NSs和DSs的测量没有相互关联。当HRSD分为两个子量表时,HRSD阴性症状子量表得分与PANSS阴性症状子量表和SANS总分以及情感平坦化子量表得分相关,而HRSD抑郁症状子量表得分不相关。结论:这些结果表明,重度抑郁症患者中存在高水平的NSs,这与抑郁症的阳性症状不同,可能构成一个不同的维度。MDD的阴性症状和DSs可能代表不同的构念。此外,重度抑郁症的HRSD可能有亚量表,就像在精神分裂症中一样。
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