The so-called “negative symptoms” of schizophrenia can determine long-term functional outcome in patients, but they are often poorly defined and measured. The implications for patients are dire: psychiatrists have very little to offer patients who suffer from these debilitating symptoms, which remain an unmet clinical need. In recent years, an increasing number of studies have shown there are at least two principal symptom ‘dimensions’ that make up the negative symptoms, namely deficits in motivation and pleasure and deficits in the ability to express emotions. In this talk, I will present our work suggesting that these dimensions not only remain independent over time, but also may have dissociable mechanisms. Our and others’ data suggest that deficits in motivation and pleasure are strongly predictive of functional outcomes. This has motivated our large, multi-site, multi-national project ‘CHAracterising Negative Symptoms in Schizophrenia’ (CHANSS), investigating the computational mechanisms of motivation and pleasure deficits. I will present data from CHANSS, which includes an extensive assessment of patient symptomatology, cognition, and the behavioural signatures of motivation and pleasure. The latter is assessed through a battery of tasks, measuring distinct mechanisms in the decision to initiate a goal-directed action. We hope this research will pave the way for new clinical trials that will target more specific deficits in the decision to engage in motivated behaviour.

 

Dr. Noham Wolpe

Senior lecturer, Faculty of Medicine, Tel Aviv University

Noham Wolpe – Clinical and computational characteristics of the negative symptoms of schizophrenia