Negative Symptoms in the Remission Phase of Bipolar Disorder

Objectives: Though negative symptoms (NS) are major contributors to sociooccupational dysfunction in schizophrenia, NS in remitted bipolar disorder (BPD) are little studied. We evaluated the prevalence and correlates of NS and their contribution to sociooccupational dysfunction in remitted BPD. Methods: Ninety remitted BPD patients, receiving only mood stabilizers, were evaluated with the Scale for Assessment of Negative Symptoms (SANS), Brief Psychiatric Rating Scale (BPRS) and Social and Occupational Functioning Assessment Scale. Forty-five normal controls matched for age, sex and total years of education were assessed with SANS. Results: NS were present in 26.67% of the patients. The patients had more severe affective flattening, alogia, anhedonia-asociality and avolition-apathy. Primary NS were associated with history of obstetric complications, family history of schizophrenia, earlier age of illness onset, history of mood incongruent psychotic features (MIPF), poor premorbid and current sociooccupational functioning and a greater decline in functioning after illness onset. Factor analysis revealed three factors which explained 62.08% of the variance secondary negative and subaffective symptoms, primary NS, and anxiety symptoms. Conclusions: As NS are prevalent in remitted BPD and contribute to the patients’ sociooccupational dysfunction, they require prompt detection and management (German J Psychiatry 2007;10: 1-7).