|Avolition or lack of motivation is one of the negative symptoms of schizophrenia. / Photo by Katarzyna Białasiewicz via 123RF|
Avolition or lack of motivation is one of the negative symptoms of schizophrenia. Although a lack of motivation or reduced drive to finish purposeful tasks is not an inherent symptom of mental disorder, it is considered to be asymptomatic of depression. The symptom occurs mostly in patients diagnosed with schizophrenia, bipolar disorder, and depression.
Avolition: The Central Domain to Successfully Treat Schizophrenia
A new study revealed that treating avolition alone creates a positive effect on other negative symptoms. The study, which appeared in The Journal of Psychoses and Related Disorders, detailed that avolition is the central domain to successfully treat schizophrenia. To come up with this conclusion, Gregory P. Strauss from the University of Georgia, Athens' Department of Psychology and the team conducted a randomized clinical trial on participants with schizophrenia.
The patients were randomly assigned to MIN101 (roluperidone), a drug that is under development by biopharmaceutical company Minerva Neurosciences for treating schizophrenia. Strauss said that there has been a lot of hope that the phase 3 trial of Minerva Neurosciences will show improvement in the negative symptoms of the chronic and severe mental disorder that affects how a person behaves, feels, and thinks.
He added that roluperidone could be the first compound that indicated possibly improving the negative symptoms of the mental disorder and get the approval of the Food and Drug Administration.
No medication for schizophrenia has yet been approved by the FDA for the treatment of the condition so if Minerva Neurosciences will be successful in its endeavor, it could provide a “monumental benefit” for patients diagnosed with schizophrenia. As of now, schizophrenia is the main medical cause of the patients’ functional disability and because of this, they struggle to accomplish daily independent activities, build social connections, and hold a job. The US government is spending a large amount of money on functional disability.
Five Domains of Negative Symptoms of Schizophrenia
The team recognized that negative symptoms of schizophrenia do not come in a single construct but five distinct domains. These are avolition, alogia (reduced speech), asociality (reduced social activity), anhedonia (reduced pleasure), and emotional blunting or blunted affect (difficulty in expressing outward expression in voice and face). Each of these domains needs individual treatment targets, the authors added.
The researchers said via medical platform Medical Xpress that previous studies on schizophrenia have focused on the function of the symptoms in isolation. For their study, they conducted a network analysis. It is a mathematical approach used in the study of complex systems science and engineering that determines the relations among actors or entities. In their study, it showed that the symptoms of schizophrenia have “dynamic casual interactions with each other.”
Participants in the study received roluperidone or a placebo. Participants who received a placebo showed that avolition was central among them while those who received roluperidone had a reduced level of centrality.
Strauss went on that even if the roluperidone drug will not decrease the severity of schizophrenia symptoms, it can have a valuable function in altering the interactions of the symptoms. They also found out that avolition is the central domain within the construct of negative symptoms, which means that the other negative symptoms of schizophrenia are tightly coupled to avolition. If the central domain will be treated successfully, it will likely create a positive effect on other negative symptoms.
Purpose of the Study
The authors suggested that future drug development for schizophrenia should focus on the avolition because if it is successfully treated, all the other negative symptoms will also be improved. Thus, it will reduce the patients’ functional disability.
Our World in Data, a scientific online publication that focuses on large global problems, shared the total number of people suffering from schizophrenia in 2017 and measured the data across all ages and both sexes. Countries with the highest number of people with schizophrenia were China (5.66 million), India (3.47 million), United States (1.15 million), Indonesia (615,331), Brazil (469,324), Mexico (258,084), Nigeria (261,533), Egypt (161,652), Russia (339,645), Iran (180,680), Thailand (198,586), Philippines (213,423), and Ethiopia (116,345).
The World Health Organization said that the mental disorder affects 20 million people globally. It is characterized by distortion in perception, thinking, sense of self and behavior, language, and emotions. Patients diagnosed with schizophrenia commonly see things or hear voices that are not seen or heard by others. Compared to the general population, people with schizophrenia are two to three times more likely to die early. No research has yet identified a single factor that causes schizophrenia but some scientists believe that it is because of the interaction between environmental factors and genes.
Until today, violation of human rights, discrimination, and stigma relating to schizophrenia exist, and more than 69% of people with the condition are not receiving the right care they need. Also, 90% of schizophrenic patients are living in low- and middle-income nations. This is the reason why providing access to mental health services is important.
With psychosocial support and medicines, schizophrenia is treatable, but most people with the condition simply lack access to appropriate treatment, the WHO added. By treatable, it means easing the symptoms of hallucinations and delusions. A recent study by Jari Tiihonen from the Karolinska Institute in Sweden and his team also suggested that long-term use of schizophrenia medicine is not a threat to the health of the patients. Their study involved 62,000 patients in Finland who were diagnosed with schizophrenia between 1972 and 2014.
Tiihonen explained that the chances of being hospitalized because of physical conditions were just as high on patients taking antipsychotic drugs and those who don’t. Antipsychotics are a class of medication primarily used to manage psychosis. In the past, antipsychotics were linked to weight gain and believed to increase the risk of heart disease. However, their study emphasized the importance of antipsychotic drugs. Building understanding and trust toward the safety and efficacy of antipsychotics even for long-term use is important, their study read.
These two new studies offer promising steps or new approaches in treating schizophrenia.