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Negative symptoms in schizophrenia: a study in a large clinical sample of patients using a novel automated method

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Rashmi Patel, Nishamali Lakshani Jayatilleke, Matthew Broadbent, Chin-Kuo Chang, Nadia Foskett, Genevieve Gorrell, Richard Derek Hayes, Richard George Jackson, Caroline Johnston, Hitesh Shetty, Angus Roberts, Philip McGuire, Robert James Stewart

Original languageEnglish
Article numbere007619
Number of pages9
JournalBMJ Open
Issue number9
StatePublished - 8 Sep 2015


King's Authors



Objectives: To identify negative symptoms in the clinical records of a large sample of patients with schizophrenia using natural language processing and assess their relationship with clinical outcomes.

Design: Observational study using an anonymised electronic health record case register.

Setting: South London and Maudsley NHS Trust (SLaM), a large provider of inpatient and community mental healthcare in the UK.

Participants: 7678 patients with schizophrenia receiving care during 2011.

Main outcome measures: Hospital admission, readmission and duration of admission.

Results: 10 different negative symptoms were ascertained with precision statistics above 0.80. 41% of patients had 2 or more negative symptoms. Negative symptoms were associated with younger age, male gender and single marital status, and with increased likelihood of hospital admission (OR 1.24, 95% CI 1.10 to 1.39), longer duration of admission (β-coefficient 20.5 days, 7.6–33.5), and increased likelihood of readmission following discharge (OR 1.58, 1.28 to 1.95).

Conclusions: Negative symptoms were common and associated with adverse clinical outcomes, consistent with evidence that these symptoms account for much of the disability associated with schizophrenia. Natural language processing provides a means of conducting research in large representative samples of patients, using data recorded during routine clinical practice.

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