[Negative dimension, social cognition, insight and subjective experience in Schizophrenia]

Investigation on subjective symptoms in schizophrenia has traditionally been limited to delusions and hallucinations, not considering the persistence of many others disorders and difficulties as residual negative symptoms and cognitive deficits that instead greatly affect the clinical and functional prognosis. The aim of the study is to investigate the differences between the subjective experience of the patient and the objective assessment regarding the negative dimension symptoms in patients with schizophrenia.

We evaluated 58 patients with a diagnosis of schizophrenia consecutively admitted at the L'Aquila Psychiatric inpatient ward (Italy) from April to September 2010; all of them were taking psychopharmacological treatment. The instruments used were: the PANSS for assessment of clinical symptoms and VGF for the assessment of the global functioning, the SENS, the Insight Self-Report Scale and the Scale Geople to investigate respectively the negative dimension subjectively perceived, the insight and the social cognition.

The analysis of SENS showed a score of 95.43 (SD ± 9.1) in the awareness, pointing to a negative perception of the experience medium to high. The study of Social Cognition has shown the presence of a statistically significant discrepancy between the two evaluations (p <0.01). The inferential analysis between SENS and PANSS, reported significant correlations between the PANSS negative symptoms of the item of inability to feel the SENS (p <0.015). Finally, a positive correlation was found between the total score of SENS with GFR (p <0.02).

The knowledge of the subjective experiences of patients with schizophrenia can be difficult because of social withdrawal and resistance to treatment, due mostly to the subjective suffering that is not adequately understood. The results, in line with the recent literature, have shown that the perception of negative symptoms does not always find a parallel in the clinical assessment and how this is a significant correlation with the global functioning. In this perspective, it is therefore necessary to consider the point of view of the patient in order to predict the adherence to the treatment and the global functioning outcome.