Depression, negative and positive symptoms, and the DST in schizophrenia.

It has been suggested that the presence of depression is a major determinant of abnormal dexamethasone suppression in patients with schizophrenia. It has been reported that negative symptoms in patients with schizophrenia are associated with increased rates of nonsuppression. In this study of schizophrenic inpatients, the Dexamethasone Suppression Test (DST), depression and negative and positive symptom ratings were carried out in two phases of the acute episode, in the second week after administration to, and in the week prior to discharge from, hospital. There was no association between depression and cortisol nonsuppression or between negative and positive symptoms and cortisol nonsuppression either early or late in the acute episode. It is concluded that the DST has no clinical utility in identifying the non-melancholic depression which occurs commonly in schizophrenia.

Psychometric properties of the Manchester Scale.

This article reports a preliminary investigation of the psychometric properties of the Manchester Scale (MS). Fifty-three patients were assessed on the instrument, 33 at time 1 (7-10 days after admission) and 53 at time 2 (during the week prior to discharge). Interrater reliabilities were generally good at time 2. The factor analyses conducted on the 8 MS items at times 1 and 2 suggest that MS contains a heterogeneous group of items: only the MS negative symptoms were related to one another. The MS positive and negative symptoms were strongly correlated with their counterpart items on the Schedules for the Assessment of Positive Symptoms and Negative Symptoms, suggesting that the MS items have good concurrent validity.

Are employment-interview skills a correlate of subtypes of schizophrenia?

46 inpatients with a DSM-III diagnosis of schizophrenia were assessed in the week prior to discharge from hospital on measures of positive and negative symptoms and on 12 measures of employment interview skills (i.e., eye contact, facial gestures, body posture, verbal content, voice volume, length of speech, motivation, self-confidence, ability to communicate, manifest adjustment, manifest intelligence, over-all interview skill), and a global measure of employability. A cluster analysis based on the total positive and negative symptom scores produced two groups. The group with the lower mean negative symptom score exhibited better employment-interview skills and higher ratings on employability.

Negative symptoms and social skills performance in schizophrenia.

The present study aimed to determine whether the negative symptoms of patients with schizophrenia were better predictors of social competence than a range of other variables pertaining to demographics, illness, hospitalization, and premorbid functioning. Independent raters assessed social skills performance on a video-taped role-play test and 5 min conversation in 53 inpatients with a DSM-III diagnosis of schizophrenia. Patients' social skills were also assessed by ward nurses. Project clinicians assessed depression, medication side effects and positive and negative symptoms. Multiple-regression analyses demonstrated that, generally, negative symptoms were the best predictors of social skills performance.

Which employment interview skills best predict the employability of schizophrenic patients?

To examine the effects of verbal and nonverbal interview microbehaviors and interview characteristics on employability, Simulated Employment Interviews were conducted with 46 psychiatric inpatients who each met the DSM-III criteria for a diagnosis of schizophrenia. Each interview was videotaped and shown to two raters, who generated independent ratings for six microbehaviors (eye-contact, facial gestures, body posture, verbal content, voice volume, and length of speech) and six subject characteristics (motivation, self-confidence, ability to communicate, manifest adjustment, manifest intelligence and overall interview skill). A panel of three Commonwealth Employment Service psychologists viewed the same videotaped interviews and generated employability ratings. Verbal and nonverbal microbehaviors were relatively independent while subject characteristics were highly interdependent. Microbehaviors and characteristics correlated at a high level. Of the 12 interview microbehaviors and characteristics, manifest adjustment and ability to communicate accounted for 64% of the total variance in predicting employability. Interviewees who were perceived as behaving in an adjusted manner and as being good communicators were rated as more employable.

Is social skills performance a correlate of schizophrenia subtypes?

53 inpatients with a DSM-III diagnosis of schizophrenia were assessed in the week prior to discharge from hospital on measures of social skills performance and on severity of positive and negative symptoms. A cluster analysis based on the total positive and negative symptom scores resulted in three groups. The group with the least negative symptoms exhibited the best social skills performance. The findings add a further dimension to the validity of the subtyping of schizophrenia on the basis of positive and negative symptoms.

Persistent psychotic symptoms at discharge in patients with schizophrenia.

A sample of patients with DSM-III schizophrenia was examined and rated using Andreasen's Schedule for the Assessment of Positive Symptoms (SAPS) and the Schedule for the Assessment of Negative Symptoms (SANS), soon after admission and in the week prior to discharge. A high proportion of the sample had persistent positive and negative symptoms at discharge. This finding is discussed in relation to the service demands placed on the hospital, changing government policies concerning hospital and community care, and the possible consequences of early discharge policies in the absence of adequate community services.