Negative symptoms and cognitive impairment in US patients with schizophrenia: a real-world descriptive study using the NeuroBlu database
Background: Negative symptoms in schizophrenia (NSS) and cognitive impairment associated with schizophrenia (CIAS) are linked to poor prognosis. Real-world data (RWD) from electronic health records (EHRs) help characterize large patient cohorts in routine mental healthcare. This study identified and characterized patients with schizophrenia with NSS or CIAS from RWD.
Methods: Retrospective cohort study using the NeuroBlu database (Version 24R2) of de-identified EHRs from US mental healthcare providers (1999-2024) was performed. Patients aged ≥18 years diagnosed with schizophrenia and ≥1 record of Mental Status Examination (MSE), Brief Negative Symptom Assessment (BNSA), or Natural Language Processing (NLP) label linked to schizophrenia were included. NSS and CIAS were assigned a priori using information from MSE, BNSA, and NLP. Demographic and clinical characteristics were compared between patients with and without NSS or CIAS.
Results: Among 44,934 patients with schizophrenia, 58.8% presented with features of NSS and 59.2% with evidence of CIAS. Patients with NSS or CIAS were younger, more often White, and had a higher burden of positive symptoms than patients without NSS or CIAS. Global Assessment of Functioning (GAF) was lower among patients with NSS ((mean (SD) NSS = 33.8 (13.3), no NSS = 44.34 (13.60)); CIAS (mean (SD) = 33.6 (12.9), no CIAS = 48.5 (12.2)).
Conclusions: Utilizing RWD, we identified patients with schizophrenia-related symptoms in a large population that is likely underrepresented in clinical trials. NSS and CIAS were prevalent among patients with schizophrenia and may contribute to a worse clinical presentation, including lower functioning.
