People with schizophrenia experience the same level of positive emotion and enjoyment as people without the disease but have a higher level of negative emotion, investigators have found.

In the study, Amy H. Sanchez and her colleagues gave people with schizophrenia (n = 47) and without schizophrenia (n = 41) a cell phone. People with active substance dependence were not included.

Participants were telephoned four times a day for 1 week, asked about their current emotional state, and how much they were enjoying their current activity. No significant differences were seen in positive emotion (P = .53) or how enjoyable activities (P = .23) were experienced between people with and without schizophrenia, reported Ms. Sanchez, from the psychology department at the San Francisco State University ( Psychiatry Res. 2014;220:89-95 ).

However, people with schizophrenia reported significantly more negative emotion (P = .003) and a weaker relationship between current enjoyment and negative emotion, compared to people without the disease (P = .04). Lower neurocognition predicted this relationship (P = .02); people with schizophrenia and poor cognitive function reported negative emotions that were more independent of how they had rated their enjoyment of activities. “An increase in activity enjoyment is connected to a decrease in negative emotion for people without schizophrenia, while there was less of a connection between appraisals of the environment and negative emotion for people with schizophrenia,” the reported the investigators, who used a methodology developed to measures experiences in-the-moment called ecological momentary assessment (EMA).

Their findings suggested that schizophrenia is not characterized by a disconnect between positive emotion and pleasurable experiences but rather is limited specifically to the elevation and dysregulation of negative emotion. “This finding highlights the importance of negative emotion as a target for research and treatment in schizophrenia,” they said.

Ms. Sanchez and her colleagues reported several limitations. One is that symptoms were assessed while the study participants were in lab assessments with clinicians rather than during the EMA assessments. “Relatedly, our measure of substance use relied on self-report during the in-lab session rather than by a more objective measure or during the EMA interview,” they wrote.

The National Institute of Mental Health funded the study. The authors declared no conflicts of interest.


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