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Evaluación clínica de los síntomas negativos de la esquizofrenia

Published online by Cambridge University Press:  12 May 2020

Hans-Jürgen Möller
Hans-Jürgen Möller*
Affiliation:
Departamento de Psiquiatría, Universidad Ludwig-Maximilians, Nussbaumstrasse 7, 80336Munich, Alemania
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Resumen

Frecuentemente, los síntomas positivos floridos de la esquizofrenia (alucinaciones, ideas delirantes, pensamiento muy desorganizado) son obvios. En comparación, los síntomas negativos (afecto embotado, pobreza del lenguaje, apatía, abolición y anhedonia) son más sutiles y difíciles de reconocer y diagnosticar. Sin embargo, está aumentando el reconocimiento de la importancia de los síntomas negativos en pacientes con esquizofrenia. Los síntomas negativos secundarios atribuibles a algunos factores, como falta de alivio de síntomas positivos, efectos adversos de los antipsicóticos o aislamiento social pueden disminuir con la resolución de dichos factores. Por el contrario, los síntomas negativos primarios son un aspecto intrínseco de la esquizofrenia; son persistentes y se asocian con resultados clínicos desfavorables. Aunque la falta de tratamiento eficaz para los síntomas negativos es una necesidad importante que no está cubierta todavía en esta población, el diagnóstico exacto sigue siendo importante. La evaluación de los síntomas negativos sospechados, usando escalas de puntuación validadas, puede ayudar a descartar los trastornos afectivos o cognitivos simultáneos que pueden simular síntomas negativos y distinguir los síntomas negativos primarios de los síntomas negativos secundarios potencialmente reversibles. Este artículo revisa las definiciones y la clasificación de los síntomas negativos, compara los instrumentos disponibles para su evaluación y propone algoritmos clínicos prácticos para sortear los posibles diagnósticos diferenciales.

Keywords

AlgoritmoDiagnósticoSíntomas negativos persistentesEsquizofrenia
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 14 , Issue 8 , November 2007 , pp. 375 - 382
Copyright
Copyright © European Psychiatric Association 2007

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