***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The Intercontinental Schizophrenia Outpatient Health Outcomes ( IC-SOHO ) study was design ed to provide information regarding use and outcome of antipsychotic treatments in a large , diverse population in real practice setting s. METHOD Out patients with schizophrenia ( ICD-10 or DSM-IV ) who initiated or changed to a new antipsychotic  entered this 3-year , naturalistic , prospect i ve observational study . Four monotherapy treatment groups were defined according to the antipsychotic prescribed at baseline , namely olanzapine , risperidone , quetiapine , and haloperidol .  Efficacy was assessed using the Clinical Global Impressions-Severity of Illness rating scale ( CGI-S ) , inclusive of subscales for positive , negative , depressive , and cognitive symptoms . Tolerability was assessed by adverse event question naires and weight measurements . Six-month findings are described . RESULTS At baseline , 5833 participants were prescribed monotherapy and the mean severity of illness was moderate to marked ( CGI-S ) . At 6 months , olanzapine result ed in significantly greater improvements in overall , positive , negative , depressive , and cognitive symptoms compared with quetiapine , risperidone or haloperidol ( p < .001 ) . Improvements in overall , negative , and cognitive symptoms were significantly higher for risperidone compared with haloperidol ( p < .001 ) , whereas improvements across all symptoms were comparable for quetiapine and haloperidol . Extra-pyramidal symptoms and tardive dyskinesia decreased compared with baseline in the olanzapine , quetiapine , and risperidone groups but increased in the haloperidol group ( p < .001 , likelihood of extrapyramidal symptoms with haloperidol compared with olanzapine , quetiapine , or risperidone ) . Sexual function adverse events were most prominent in the haloperidol and risperidone treatment groups . Weight change was significantly greater for olanzapine compared with the other antipsychotics ( p < .001 ) . CONCLUSION Our results support the previously reported positive impact of atypical antipsychotics , particularly olanzapine , in patients with schizophrenia BACKGROUND Amisulpride is a substituted benzamide with high selectivity for dopamine D2 and D3 receptors . The purpose of the study was to evaluate the effect of 100 mg amisulpride in patients with predominantly negative symptoms of schizophrenia . METHOD This was a multi-centre , r and omised , parallel-group , double-blind study . Patients received either amisulpride ( 100 mg/day ) or placebo over a six-month treatment period . RESULTS A total of 141 patients were included , 69 received amisulpride , 72 placebo .  Fifty-eight patients ( 41 % ) had received neuroleptic treatment prior to inclusion . The percentage of amisulpride patients completing the study ( 55 % ) was significantly higher than that with placebo ( 32 % ) , and drop-out rates due to lack of efficacy were 27 % with amisulpride and 47 % with placebo . All efficacy assessment s were statistically in favour of amisulpride compared with placebo . The overall incidence of extrapyramidal symptoms was comparable in both groups ; only five patients started anti-Parkinsonian treatment during the study ( one in the placebo and four in the amisulpride group ) . CONCLUSION Amisulpride is effective in the medium-term treatment schizophrenic patients with predominantly negative symptoms Based on the evidence that lamotrigine added to clozapine in refractory schizophrenic patients has reported promising results , the present 24-week double-blind , r and omized , placebo-controlled trial had the aim to explore the efficacy of lamotrigine add-on pharmacotherapy on clinical symptomatology and cognitive functioning in a sample of treatment-resistant schizophrenic patients receiving clozapine .  After clinical and neurocognitive assessment s patients were r and omly allocated to receive , in a double-blind design , either up to 200 mg/day of lamotrigine or a placebo .  A final sample of fifty-one patients completed the study . The results obtained indicate that lamotrigine added to stable clozapine treatment showed a beneficial effect on the negative , positive and general psychopathological symptomatology in a sample of treatment-resistant schizophrenic patients . Regarding cognitive functions , improvement was observed in some explored areas , such as attentional resistance to interference , verbal fluency and executive functioning . The findings provide evidence that lamotrigine augmentation of clozapine treatment is well tolerated and may be proposed as an effective therapeutic strategy to improve outcome in treatment-resistant schizophrenia BACKGROUND The purpose of this investigation was to test the efficacy of novel antipsychotic medications in the treatment of  cognitive impairment in early phase schizophrenia . METHODS Sixty-five patients in this multicenter double-blind study were r and omly assigned to olanzapine ( 5 - 20 mg ) , risperidone ( 4 - 10 mg ) , or haloperidol ( 5 - 20 mg ) . St and ard measures of clinical and motor syndromes were administered , as well as a comprehensive battery of tests to assess ( 1 ) motor skills , ( 2 ) attention span , ( 3 ) verbal fluency and reasoning , ( 4 ) nonverbal fluency and construction , ( 5 ) executive skills , and ( 6 ) immediate recall at baseline and after 6 , 30 , and 54 weeks of treatment . RESULTS The general cognitive index derived from the 6 domain scores revealed a significantly greater benefit from treatment with olanzapine relative to haloperidol and olanzapine relative to risperidone , but no significant difference was shown between risperidone and haloperidol . The improvement related to olanzapine was apparent after 6 weeks and enhanced after 30 and 54 weeks of treatment . Exploratory within-group analyses of the 6 cognitive domains after a conservative Bonferroni adjustment revealed a significant improvement with olanzapine only on the immediate recall domain , and similar analyses of the 17 individual tests revealed a significant improvement with olanzapine only on the Hooper Visual Organization Test . CONCLUSIONS These data suggest that olanzapine has some superior cognitive benefits relative to haloperidol and risperidone . A larger sample replication study is necessary to confirm and generalize the observations of this study and begin evaluation of the implication s of this change to cerebral function and quality of life for people with schizophrenia BACKGROUND Patient-clinician communication is central to mental healthcare but neglected in research . AIMS To test a new computer-mediated intervention structuring patient-clinician dialogue ( DIALOG ) focusing on patients ' quality of life and needs for care . METHOD In a cluster r and omised controlled trial , 134 keyworkers in six countries were allocated to DIALOG  or  treatment as usual ; 507 people with schizophrenia or related disorders were included . Every 2 months for 1 year , clinicians asked patients to rate satisfaction with quality of life and treatment , and request additional or different support . Responses were fed back immediately in screen displays , compared with previous ratings and discussed . Primary outcome was subjective quality of life , and secondary outcomes were unmet needs and treatment satisfaction . RESULTS Of 507 patients , 56 were lost to follow-up and 451 were included in intention-to-treat analyses . Patients receiving the DIALOG intervention had better subjective quality of life , fewer unmet needs and higher treatment satisfaction after 12 months . CONCLUSIONS Structuring patient-clinician dialogue to focus on patients ' views positively influenced quality of life , needs for care and treatment satisfaction BACKGROUND It is difficult to improve negative symptoms and cognitive impairments in schizophrenia . A previous pilot study has shown that minocycline , a semi-synthetic second-generation tetracycline , is effective in treating for negative and /or cognitive symptoms in schizophrenia . OBJECTIVES The present study was design ed to examine the efficacy and safety of minocycline for the treatment of negative symptoms and cognitive impairments in patients with schizophrenia . METHODS Ninety-two patients with early stage schizophrenia treated with risperidone  entered this 16-week , double blind , r and omized , placebo-controlled clinical trial . Subjects were r and omly assigned to receive minocycline ( 200 mg per day ) or the placebo . The primary outcome was evaluated using the Scale for the Assessment of Negative Symptoms ( SANS ) . Secondary outcomes included the response rate of SANS , the Positive and Negative Syndrome Scale ( PANSS ) , the Clinical Global Impression Scale ( CGI ) , and cognitive tests . RESULTS Subjects receiving minocycline had greater improvements on SANS total scores and PANSS negative subscale scores ( P<0.001 ) when compared with those receiving the placebo . Rates of treatment response ( 43.6 % ) in the minocycline group were significantly higher than those in the placebo group ( 10.0 % ) after 16weeks of treatment . There was no significant difference between the seven cognitive domains ( P>0.05 ) , except for the attention domain ( P=0.044 ) . CONCLUSIONS The addition of minocycline to atypical antipsychotic drugs in early schizophrenia had significant efficacy on negative symptoms but had a slight effect on the attention domains of patients with schizophrenia . It may be considered as a new adjunct treatment for negative symptoms of schizophrenia . Clinical trials.gov identifier : NCT01493622 This prospect i ve longitudinal 15-year multifollow-up research studied whether  unmedicated patients with schizophrenia can function as well as schizophrenia patients on antipsychotic medications . If so , can differences in premorbid characteristics and personality factors account for this ? One hundred and forty-five patients , including 64 with schizophrenia , were evaluated on premorbid variables , assessed prospect ively at index hospitalization , and then followed up 5 times over 15 years . At each follow-up , patients were compared on symptoms and global outcome . A larger percent of schizophrenia patients not on antipsychotics showed periods of recovery and better global functioning ( p < .001 ) . The longitudinal data identify a subgroup of schizophrenia patients who do not immediately relapse while off antipsychotics and experience intervals of recovery . Their more favorable outcome is associated with internal characteristics of the patients , including better premorbid developmental achievements , favorable personality and attitudinal approaches , less vulnerability , greater resilience , and favorable prognostic factors . The current longitudinal data suggest not all schizophrenia patients need to use antipsychotic medications continuously throughout their lives This exploratory trial was conducted to test the effects of an alpha7 nicotinic receptor partial agonist , TC-5619 , on cognitive dysfunction and negative symptoms in subjects with schizophrenia . In the United States and India , 185 out patients ( 18–60 years ; male 69 % ; 46 % tobacco users ) with schizophrenia treated with quetiapine or risperidone monotherapy  were r and omized to 12 weeks of placebo ( n=91 ) or TC-5619 ( n=94 ; orally once daily 1 mg day 1 to week 4 , 5 mg week 4 to 8 , and 25 mg week 8 to 12 ) . The primary efficacy outcome measure was the  Groton Maze Learning Task ( GMLT ; executive function ) of the CogState Schizophrenia Battery ( CSB ) . Secondary outcome measures included : CSB composite score ; Scale for Assessment of Negative Symptoms ( SANS ) ; Clinical Global Impression-Global Improvement ( CGI-I ) ; CGI-severity ( CGI-S ) ; and Subject Global Impression-Cognition . GMLT statistically favored TC-5619 ( P=0.036 ) in this exploratory trial . SANS also statistically favored TC-5619 ( P=0.030 ) . No other secondary outcome measure demonstrated a drug effect in the total population ; there was a statistically significant drug effect on working memory in tobacco users . The results were typically stronger in favor of TC-5619 in tobacco users and occasionally better in the United States than in India . TC-5619 was generally well tolerated with no clinical ly noteworthy safety findings . These results support the potential benefits of TC-5619 and alpha7 nicotinic receptor partial agonists for cognitive dysfunction and negative symptoms in schizophrenia BACKGROUND Cognitive deficits are recognized as a critical determinant of functional outcomes in schizophrenia ; and second generation antipsychotic drugs have been touted for their potential to enhance cognitive functioning and community tenure . OBJECTIVES The study examined the relative merits of olanzapine and quetiapine in improving cognitive deficits and enhancing psychosocial functioning in a sample of community dwelling adults previously treated with first generation antipsychotic drugs for schizophrenia . METHODS In a prospect i ve , rater-blinded study , 86 participants were r and omized to receive either olanzapine or quetiapine , and assessed at baseline and after 3 , 6 , 9 and 12 months . Outcome measures included , besides symptoms and side effects rating scales , the subjective scale to investigate cognition in schizophrenia ( SSTICS ) , a computer-assisted cognitive test battery ( COGLAB ) , the sickness impact profile ( SIP ) , the global assessment of functioning ( GAF ) scale , and the drug attitude inventory ( DAI ) . RES 
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In a multivariate meta-regression , only the type of scale used was found to significantly influence negative symptom change .
No difference in outcome was found between studies that excluded patients with a high level of positive or depressive symptoms , compared to those that did not .
Negative symptoms were found to reduce in almost all schizophrenia outpatient sample s. A reduction was found across all conditions , with effect sizes ranging from small to large depending upon the condition type .
These findings challenge the convention that negative symptoms are highly stable and suggest that they may improve to a greater extent than what has previously been assumed