{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:45:21Z","timestamp":1787021121731,"version":"build-2736575974"},"reference-count":10,"publisher":"Royal College of Psychiatrists","issue":"1","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Negative symptoms of schizophrenia manifest as reduced motivation and pleasure (MAP) and impaired emotional expressivity (EXP). These can occur as primary phenomena, but have also been suggested to occur secondary to other clinical factors, including antipsychotic-induced sedation. However, this relationship has not been established formally. Here, we examined the effect of antipsychotic-induced sedation (assessed via the proxy of total daily sleep duration) on MAP and EXP in a cohort of 187 clozapine-treated patients with schizophrenia followed for over 2 years on average, using multilevel regression and mediation models. MAP, but not EXP, was adversely influenced by sedation, independently of the severity of psychosis or depression. Moreover, clozapine impaired MAP indirectly by worsening sedation, but after accounting for clozapine-induced sedation, clozapine improved MAP. Our results highlight the importance of addressing sedative side-effects of antipsychotics to improve clinical outcomes.<\/jats:p>","DOI":"10.1192\/bjp.2022.191","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T01:43:37Z","timestamp":1673315017000},"page":"295-297","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":12,"title":["Longitudinal effect of clozapine-associated sedation on motivation in schizophrenia: naturalistic longitudinal study"],"prefix":"10.1192","volume":"223","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4652-7727","authenticated-orcid":false,"given":"Noham","family":"Wolpe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4724-4892","authenticated-orcid":false,"given":"Shanquan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Kirkpatrick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0387-880X","authenticated-orcid":false,"given":"Peter B.","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Jenkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8751-5167","authenticated-orcid":false,"given":"Rudolf N.","family":"Cardinal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4128-8955","authenticated-orcid":false,"given":"Emilio","family":"Fernandez-Egea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2023,1,10]]},"reference":[{"key":"S000712502200191X_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2022.03.004"},{"key":"S000712502200191X_ref4","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1978.01770330075006"},{"key":"S000712502200191X_ref3","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sbq059"},{"key":"S000712502200191X_ref8","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.156.1.88"},{"key":"S000712502200191X_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31135-3"},{"key":"S000712502200191X_ref6","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0000000000001432"},{"key":"S000712502200191X_ref9","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1176\/ajp.155.6.751","article-title":"Positive and negative symptom response to clozapine in schizophrenic patients with and without the deficit syndrome","volume":"155","author":"Buchanan","year":"1998","journal-title":"Am J Psychiatry"},{"key":"S000712502200191X_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(18)30050-6"},{"key":"S000712502200191X_ref2","doi-asserted-by":"publisher","DOI":"10.1093\/schbul\/sby169"},{"key":"S000712502200191X_ref7","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.191.50.s7"}],"container-title":["The British Journal of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S000712502200191X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T18:25:12Z","timestamp":1728671112000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S000712502200191X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,10]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["S000712502200191X"],"URL":"https:\/\/doi.org\/10.1192\/bjp.2022.191","relation":{},"ISSN":["0007-1250","1472-1465"],"issn-type":[{"value":"0007-1250","type":"print"},{"value":"1472-1465","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,10]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}