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Negative symptoms and social and occupational functioning differentiate systematic paraphrenia from schizophrenia: results from a cross-sectional study

Published online by Cambridge University Press:  01 September 2022

L.A. Fernandes*
Affiliation:
Hospital Prof. Doutor Fernando Fonseca EPE, Psychiatry, Amadora, Portugal
B. Trancas
Affiliation:
Hospital Prof. Doutor Fernando Fonseca EPE, Psychiatry, Amadora, Portugal
T. Maia
Affiliation:
Hospital Prof. Doutor Fernando Fonseca EPE, Psychiatry, Amadora, Portugal
N. Borja Santos
Affiliation:
Hospital Prof. Doutor Fernando Fonseca EPE, Psychiatry, Amadora, Portugal
*
*Corresponding author.

Abstract

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Introduction

Kraepelin’s systematic paraphrenia (SP) has been historically used to identify a group of patients in the psychosis-spectrum with good global functioning and reduced impairment in volition and emotions.

Objectives

Cross-sectional study comparing a group of patients with SP with another with schizophrenia (SZ).

Methods

We consecutively recruited SP cases from a single centre. SZ cases were selected to match those in the SP group in terms of age and sex. We diagnosed SP using the Munro Criteria and SZ using ICD-10. We collected standard sociodemographic and clinical data. All patients were under follow-up in a community mental health team at the time of the study. We used PANSS total score (PANSS-TS) to assess disease severity and its subscales to evaluate positive (PANSS-P) and negative (PANSS-N) symptoms, and general psychopathology (PANSS-GP). We applied SOFAS to assess social and occupational functioning.

Results

We recruited 32 patients, 16 with a diagnosis of SP and 16 with a diagnosis of SZ. The two groups did not differ in terms of sociodemographic data. SP cases showed lower values for PANSS-TS (SP: mean=51.63±12.49; SZ=77.76±14.12; p<0.001), PANSS-NS (SP: mean=15.50±5.97; SZ: mean=26.06±5.39; p<0.001), and PANSS-GP (SP: mean=24.31±5.51; SZ: mean=37.13±5.62; p<0.001). Groups did not differ in terms of positive symptoms. SOFAS scores were significantly higher in SP (SP: median=68, interquartile range (IQR)=19; SZ: median=41, IQR=24; p<0.01). PNSS-NS negatively correlated with SOFAS only in the SP group (r=-0.716; p=0.002).

Conclusions

SP differs from SZ in negative symptoms and social and occupational functioning. These findings suggest clinical features can differentiate SP from SZ.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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