Negative symptoms in schizophrenia: Modeling the role of experience factor and expression factor

Negative symptoms in schizophrenia can be explained by two factors, experience and expression, which should be considered as separate symptoms. However, their relative role in real world functioning has not been clarified. This study aimed to clarify the relative role of experience and expression in real world functioning, and their associations with positive symptoms and neurocognitive function. In total 107 patients with schizophrenia were enrolled. The Social Function and the Brief Negative Symptom Scales were used to evaluate the real world functioning and negative symptoms, respectively. The analysis showed that the expression factor influenced real world functioning through the experience factor. In addition, neurocognitive function affected real world functioning independent of expression and experience. These results suggested that interventions that enhance the communicative expression, such as oxytocin therapy and SST, could successfully be combined with motivational interventions, such as the cognitive behavioral therapy. In addition, real world functioning could be improved by separately performing interventions to compensate for vulnerabilities in neurocognitive function and motivation.