Part 2: Chasing Cognitive and Negative Symptoms: Unmet Treatment Needs of Patients with Schizophrenia


Negative symptoms contribute to poor functional outcomes in schizophrenia. Evaluating different symptom domains and understanding the disorder’s reward circuitry can help with intervention and patients’ leading more fulfilling lives. 

Learning Objective

After completing the educational activities, learners will be able to: 

Assess patients with schizophrenia for needs that are not met with current treatment strategies   

Target Audience

Psychiatrists, psychiatry PAs, and psychiatry NPs 

Program Description

While positive symptoms, i.e. those that reflect an excess or distortion of normal functions, are the symptoms that are most associated with and most observable in schizophrenia, negative symptoms account for a large part of long-term disability and poor functional outcomes in patients with the disorder. Negative symptoms can be described as a lessening or absence of normal behaviors and functions related to motivation and interest or verbal or emotional expression, such as blunted affect, asociality, and anhedonia. Evaluating different domains of negative symptoms separately to better understand their impact on functional outcomes, particularly cognitive symptoms, is important in the treatment of patients with schizophrenia, especially intervening to help break the cycle of symptom maintenance. Understanding the reward circuitry implicated in schizophrenia can help clinicians intervene and lead to patients having more fulfilling lives. 

From the Series: Revisiting the Relapse and Remission Roller Coaster: Safety and Efficacy of Novel Schizophrenia Treatments

Activity summary
Available credit: 
  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 Participation
Activity opens: 
Activity expires: 

Support Statement

Supported by educational grants from Alkermes, Inc. and Sunovion Pharmaceuticals, Inc. 

Learning Objective

After completing this educational activity, you should be able to:

Assess patients with schizophrenia for needs that are not met with current treatment strategies   

Release, Review, and Expiration Dates

This CME activity was published in November 2022 and is eligible for AMA PRA Category 1 Credit™ through December 31, 2023. 

Statement of Need and Purpose

The goals of schizophrenia treatment are to control symptoms, prevent relapse, and improve functioning and quality of life. For many patients, these goals are not met, and as a result, recovery rates in schizophrenia have not improved. Over the last 70 years, the treatment efficacy landscape has not changed. Antipsychotic medications are effective in treating the positive symptoms but have little to no effect on cognitive or negative symptoms. Additionally, although side effects of antipsychotics can reduce patient adherence to medication, many clinicians underestimate the impact of adverse effects such as weight gain to adherence and do not routinely provide recommended monitoring. Furthermore, many clinicians support the use of a patient-centered approach to schizophrenia treatment, but evidence suggests that it does not routinely occur. To better recognize and address patients’ unmet needs, clinicians need education on a patient-centered approach, symptom domains, adverse effects, and the potential impact of novel treatments. Novel oral medications have been approved by the FDA recently and others are in late-stage development; these treatments have novel mechanisms of action or are combinations of agents that may offer efficacy for cognitive and negative symptoms and improved adherence due to more favorable adverse event profiles. 

Unlabeled and Investigational Usage

The faculty of this educational activity may include discussions of products or devices that are not currently labeled for use by the FDA. Faculty members have been advised to disclose to the audience any reference to an unlabeled or investigational use. 

No endorsement of unapproved products or uses is made or implied by coverage of these products or uses. 

Please refer to the official prescribing information for each product for discussion of approved indicators, contraindications and warnings. 

Review Process

The faculty members agreed to provide a balanced and evidence-based presentation and discussed the topics and CME objectives during the planning sessions. The faculty’s submitted content was validated by CME Institute staff, and the activity was evaluated for accuracy, use of evidence, and fair balance by the Chair. 

The opinions expressed herein are those of the faculty and do not necessarily reflect the opinions of the CME provider and publisher or the commercial supporter 

© Copyright 2022 Physicians Postgraduate Press, Inc.

Faculty Affiliation

Dawn I. Velligan, PhD 
Professor and Co-Director 
Division of Schizophrenia and Related Disorders 
Department of Psychiatry 
The University of Texas Health Science Center at San Antonio 
San Antonio, TX 

Sanjai Rao, MD 
Clinical Professor 
University of California San Diego 
Inpatient Psychiatrist, San Diego VA 
San Diego, CA 


Faculty Disclosure

The CME Institute adheres to the Standards for Integrity and Independence in Accredited Continuing Education of the Accreditation Council for Continuing Medical Education (ACCME). Any individuals in a position to control the content of a continuing education activity, including faculty, content developers, reviewers, staff, and others, are required to disclose to learners the presence or absence of any relevant financial relationships with an ACCME-defined ineligible company within the preceding 24 months of the activity. The ACCME defines an “ineligible company” as one whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. 

The CME Institute has mitigated all relevant conflicts of interest prior to the commencement of the activity. None of the individuals involved in the content have relevant financial relationships with ineligible companies except the following: 

Individual Financial Disclosures

Dr Velligan has served as a consultant for Merck, Alkermes, Otsuka, Janssen; received grant/research support from Biogen; received honoraria from Janssen, Otsuka; and has served on the advisory boards for Merck, Janssen, Otsuka, and Alkermes. Dr Rao has served as a consultant for Janssen, Alkermes; and has received honoraria from Janssen, Alkermes, Otsuka, and Neurocrine. 

Michael R. Page, PharmD, RPh
Independent Medical Director/Medical Writer  
Plainsboro, New Jersey  
Dr. Page is a consultant for BioCentric, Inc. and American Medical Communications, Inc.  

Matthew Macaluso, DO 
Clinical Director, UAB Depression and Suicide Center 
Principal investigator for AssureRx/Myriad, Avanir, Boehringer-Ingelheim, Electrocore, Janssen, Liva Nova, Merck, Neurocrine, Novartis, Otsuka; Speaker bureau, Janssen pharmaceuticals (relationship ended); Consultant, Nusachi labs and PharmaTher.   

None of the other planners, reviewers, and CME Institute staff for this educational activity have relevant financial relationships with ineligible companies to disclose. All relevant financial relationships have been mitigated. 

Accreditation Statement

The CME Institute of Physicians Postgraduate Press, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation

The CME Institute of Physicians Postgraduate Press, Inc., designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

To obtain credit for this activity, study the material and complete the CME Posttest and Evaluation.

Available Credit

  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 Participation


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