Negative symptoms, such as diminished ability to experience pleasure and express emotional responses for appropriate social interaction, have been conventionally considered to be specific to patients with schizophrenia. However, this traditional view has been challenged by accumulating evidence showing that these symptoms are also exhibited by bipolar disorder (BD) and major depressive disorder (MDD). Whilst the manifestations of these symptoms in different mental disorders can be similar, its underlying psychopathological mechanisms may differ.
Recently, Dr. Raymond Chan’s team from the NACN Laboratory, CAS Key Laboratory of Mental Health, the Institute of Psychology, Chinese Academy of Sciences and his collaborators have administered two sets of second-generation clinical assessment of negative symptoms, the Clinical Assessment Interview for Negative Symptoms (CAINS) and the Brief Negative Symptom Scale (BNSS), to a large group of patients with schizophrenia, their findings showed that the motivation and pleasure (MAP) and the diminished expression (EXP) factors were the robust latent structure. However, it is still unclear whether the factor structure of negative symptoms would also be exhibited in patients with bipolar disorder and major depressive disorder.
In order to further address such an unclear issue, Chan’s team and Prof. Zhenghui Yi’s team from Shanghai Mental Health Center administered the CAINS and the BNSS to 152 BD patients and 179 MDD patients to examine the latent factor structure of negative symptoms in these two clinical groups. They also conducted confirmatory factor analysis to rigorously test different competitive models. Their findings showed that the two-factor model of MAP and EXP provided the best model fit than other competing models. The same findings were found when they conducted the analysis in the MDD alone sample, the BD alone sample, and the combined clinical samples.
Together, these findings suggest that MAP and EXP appear to be a stable transdiagnostic latent structure of negative symptoms across BD and MDD. Dr. Chan’s team is now conducting a project to examine the underlying neural mechanism associating with the MAP and EXP factors of negative symptoms in both clinical and subclinical samples. They hope clarifying negative symptoms in transdiagnostic and subclinical populations can facilitate development of precisive assessment and intervention for these psychopathologies.
This study was a joint collaboration with Prof. Zheng-hui Yi from Shanghai Mental Health Center. Lishuaibiao is the first author, and Prof. Yi and Dr. Chan are the co-corresponding authors.
The study was supported by grants from the Jiangsu Provincial Key Research and Development Programme, the Science Foundation of Shanghai Mental Health Centre, the CAS Key Laboratory of Mental Health, Institute of Psychology, Scientific Foundation of Institute of Psychology, Chinese Academy of Sciences, the Philip K. H. Wong Foundation, the National Natural Science Foundation of China, Shanghai Science and the Technology Innovation Action Plan Natural Science Fund Project.
This paper is now available online from European Archives of Psychiatry and Clinical Neuroscience
- Li, S. B., Zhang, J. B., Liu, C., Wang, L. L., Hu, H. X., Chu, M. Y., Wang, Y., Lv, Q. Y., Lui, S. S. Y., Yi, Z. H.*, Chan, R. C. K.* (2024). A transdiagnostic approach of negative symptoms in psychiatric disorders: Replication of a two-factor structure in major depressive disorder and bipolar disorder.
Related publications:
- Chan, R. C. K.*, Wang, L. L., Lui, S. S. Y. (2022). Theories and models of negative symptoms in schizophrenia and clinical implications. Nature Reviews Psychology, 1, 454-467.
- Li, S. B.#, Liu, C.#, Zhang, J. B.#, Wang, L. L., Hu, H. X., Chu, M. Y., Wang, Y., Lv, Q. Y., Lui, S. S. Y., Cheung E. F. C., Yi. Z. H.*, Chan, R. K. C.* (2022).Revisiting the latent structure of negative symptoms in schizophrenia: Evidence from two second-generation clinical assessments. Schizophrenia Research, 248, 131-139
