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Emotion-behaviour Decoupling and Experiential Pleasure Deficits May Differentiate Schizophrenia Patients with Different Moderate Term Outcomes

Jan 31, 2023

Failure to translate emotion into motivated behaviour is thought to contribute to the formation of negative symptoms in schizophrenia. Dr. Raymond Chan and his team from the Institute of Psychology of the Chinese Academy of Sciences (CAS) have shown that patients with schizophrenia, major depressive disorder and bipolar disorder exhibited exhibit a reduced ability to experience pleasure as well as a lack of motivation, and that the pattern of emotion-behaviour dissociation is different across schizophrenia, bipolar disorder and major depressive disorder.

Although the evidence gathered in Dr. Chan's previous cross-sectional research generally supports this notion, very few studies have adopted a longitudinal approach to investigate the predictive ability of emotion-behaviour decoupling, experiential pleasure and expression, for moderate to long-term clinical and functional outcomes in schizophrenia patients.

To address this knowledge gap, Dr. Raymond and his team collaborated with Dr. Simon Lui at University of Hong Kong, and clinicians in Hong Kong Castle Peak Hospital, to investigate this important area. They recruited 127 first-episode schizophrenia patients with baseline measures of emotion-behaviour coupling, experiential pleasure and expression, and reassessed 85 patients more than two years later.

A second-generation negative symptom scale, the Clinical Assessment Interview for Negative Symptoms and a clinician-rated sacle of social functioning were used as outcome measured. They categorized the baseline cohort empirically into groups with different degrees of emotion-behaviour coupling, experiential pleasure and expression using cluster analysis.

Their results suggested that the cluster with more severe emotion-behaviour decoupling and experiential pleasure deficits had the worst endpoint social functioning and more severe negative symptoms endpoint. Emotional expression deficits appeared to play little role in differentiating subjects into different clinical and functional outcomes.

Taken together, this work provides important empirical evidence for potential use of neurocognitive markers and emotion processing deficits in identifying schizophrenia patients with poor moderate to long-term outcome. It also provides evidence for a longitudinal association between emotion-behaviour decoupling and negative symptoms of schizophrenia.

Results have been published online in Asian Journal of Psychiatry. 

This study was supported by the General Research Fund of the Research Grant Council granted to Simon Lui. Raymond Chan was supported by the Scientific Foundation of the Institute of Psychology of CAS and the Phillip K.H. Wong Foundation.

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LIU Chen

Institute of Psychology

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Emotion-behaviour decoupling and experiential pleasure deficits predict negative symptoms and functional outcome in first-episode schizophrenia patients

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