Современная концептуализация негативной симптоматики при шизофрении
Всемирная психиатрия. №1 2017
Современная концептуализация негативной симптоматики при шизофрении
Stephen R. Marder1, Silvana Galderisi2
Desert Pacific Mental Illness Research, Education, and Clinical Center, Semel Institute for Neuroscience at UCLA, Los Angeles, CA, USA; 2 Department of Psychiatry, University of Naples SUN, Naples, Italy
Стр. 14-24
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Опубликовано: 1 февраля 2017
Аннотация / Abstract
a:2:{s:4:"TEXT";s:65534:"a:2:{s:4:"TYPE";s:4:"HTML";s:4:"TEXT";s:97165:"На протяжении длительного времени негативная симптоматика рассматривалась как главный аспект шизофрении. Она играет важную роль в функциональном исходе болезни, а возможность влияния на ее проявления до сих пор отсутствует. Для содействия исследованиям, направленным разработку эффективных мер, необходимо внести корректировки в само определение понятия, его характеристики, инструменты оценки и экспериментальные модели. На данный момент было достигнуто единое мнение относительно следующих аспектов: а) в понятие негативной симптоматики входят пять компонентов - это притупленный аффект, алогия, ангедония, асоциальность и абулия; б) в каждом компоненте следует отделять первичные проявления от проявлений, вызванных такими факторами, как эффект от лекарственного препарата, психотические симптомы или депрессия;в) все пять компонентов делятся на две группы, в первую входят притупленный аффект и алогия, а вторая группа состоит из ангедонии, асоциальности и абулии. В этой статье мы даем ныне действующее определение каждой группе; выделяем отличия среди основных инструментов оценки, показываем количественные показатели, если они есть, а также их взаимосвязь с результатами, полученными с помощью шкалы оценки; а также показываем связь с экспериментальными моделями. Мы пришли к выводам, что: а) оценка понятия негативной симптоматики в последнее время была доработана, но даже существующие экспертные консенсусные инструменты различаются по некоторым аспектам; б) использование объективных измерений может способствовать преодолению неточностей в используемых оценочных шкалах, однако данные измерения нуждаются в дальнейшем рассмотрении и подтверждении; в) границы с другими компонентами расстройства, в частности с нейрокогнициями и социальными когнициями, еще до конца не определены, и г) без дальнейшей, более четкой формулировки понятия негативной симптоматики, попытки разработать эффективные мероприятия ск...
На протяжении длительного времени негативная симптоматика рассматривалась как главный аспект шизофрении. Она играет важную роль в функциональном исходе болезни, а возможность влияния на ее проявления до сих пор отсутствует. Для содействия исследованиям, направленным разработку эффективных мер, необходимо внести корректировки в само определение понятия, его характеристики, инструменты оценки и экспериментальные модели. На данный момент было достигнуто единое мнение относительно следующих аспектов: а) в понятие негативной симптоматики входят пять компонентов - это притупленный аффект, алогия, ангедония, асоциальность и абулия; б) в каждом компоненте следует отделять первичные проявления от проявлений, вызванных такими факторами, как эффект от лекарственного препарата, психотические симптомы или д...
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