Citation: Ponizovsky AM, Barshtein G, Nechamkin Y, Ritsner M, Yedgar S and Bergelson LD. Erythrocyte Aggregability Enables the Distinction between Negative and Depressive Symptoms among Schizophrenia and Schizoaffective Disorder Patients. Ann Depress Anxiety. 2014;1(7): 7. Ann Depress Anxiety - Volume 1 Issue 7 - 2014 Submit your Manuscript | www.austinpublishinggroup.com Ponizovsky et al. © All rights are reserved Annals of Depression and Anxiety Open Access Abstract Objective: Based on the membrane-phospholipid hypothesis of schizophrenia, the authors tested the assumption that erythrocyte aggregation is differentially associated with negative and depressive symptoms of schizophrenia and schizoaffective disorder. Methods: A cell low properties analyzer was used to measure erythrocyte aggregation levels in 68 in patients with schizophrenia and schizoaffective disorder between ages 18 and 60 years and 30 normal comparison subjects without known neuropsychiatric disorders, proportionally matched for age and gender. Positive, negative and general psychopathological symptoms were quantiied with the Positive and Negative Syndrome Scale (PANSS). Multiple regression analysis was used to examine the association of erythrocyte aggregation with clinical symptoms. Results: There were no signiicant differences in erythrocyte aggregation levels between schizophrenic and schizoaffective disorder patients and normal control subjects. The erythrocyte aggregability directly and strongly correlated with the severity of negative syndrome, but inversely with affective components of the disorders. These indings were unrelated to gender, age at testing, age at onset and duration of the illnesses, body mass index, serum cholesterol and ibrinogen levels, smoking, and current medication. Conclusion: The indings provide evidence that erythrocyte aggregation may serve as a potential endophenotype marker to distinguish negative and depressive features in schizophrenia and schizoaffective disorder patients. Keywords: Schizophrenia; Schizoaffective disorder; Symptom dimensions; Erythrocyte aggregability; Peripheral marker oten treatment-resistant with conventional and even with atypical antipsychotics, and responsible for the bulk of disability caused by the disease. Because the distinction between NS and PS is based exclusively on behavioral criteria and most individuals with schizophrenia display a mixed positive negative symptomatology, physiological and biochemical criteria have been sought for the assessment of the two syndromes [2,4,5]. Both schizophrenia subtypes were found to be associated with impaired regional cerebral blood low (rCBF) [6-9], but ater neuroleptic treatment this impairment could be correlated only with NS [10,11]. In accord with that it has been found that PANSS negative scores correlate with rCBF in the cingulate gyrus and other brain regions [12]. Recent biochemical, cerebral magnetic resonance spectroscopy, and molecular genetic indings support the membrane phospholipid hypothesis of schizophrenia [13]. his hypothesis suggests that phospholipid metabolism is disturbed in schizophrenia, and various abnormalities in the composition and structure of brain and blood cell membranes diferentially correlate with negative and positive symptoms of the illness [14-16]. For instance, red blood cells (RBCs) Abbreviations RBC: Red Blood Cell; BMI: Body Mass Index; EPUFAs: Essential Polyunsaturated Fatty Acids; DSM-IV: Diagnostic Statistical Manual; PANSS: Positive and Negative Syndromes Scale; SCID: Structured Clinical Interview for DSM-IV; CGI: Clinical Global Impression scale; GAF: Global Assessment of Functioning scale; DDD: Deined Daily Dose; PBS: Phosphate Bufered Saline; AAS: Average Aggregate Size. Introduction Schizophrenia is a severe mental illness with polymorphic symptomatology, unknown etiology and complex pathophysiology. he core features of schizophrenia are conventionally separated, by behavioral criteria, into two major types: the positive (psychotic) syndrome (PS) characterized by hallucinations, delusions and thought disorders and the Negative Syndrome (NS) characterized by apathy, emotional blunting, avolition and alogia [1-4]. his dichotomy has important clinical and prognostic signiicance. While the positive symptoms are preponderant at onset of the illness or in phases of acute exacerbation and may be improved with drug therapy, the negative symptoms appear generally in the chronic course, are Research Article Erythrocyte Aggregability Enables the Distinction between Negative and Depressive Symptoms among Schizophrenia and Schizoaffective Disorder Patients Alexander M Ponizovsky 1,2 *, Gregory Barshtein 4 , Yakov Nechamkin 1 , Michael Ritsner 1,3 , Saul Yedgar 4 and Lev D Bergelson 5 1 Institute for Psychiatric Research, Sha’ar Menashe Mental Health Center, Israel 2 Mental Health Services, Ministry of Health, Israel 3 Department of Psychiatry, Bruce Rappaport Faculty of Medicine, Israel 4 Department of Biochemistry, Hebrew University, Jerusalem 5 Laboratory of Biological Membranes, Hebrew University, Jerusalem *Corresponding author: Alexander M Ponizovsky, Mental Health Services, Ministry of Health, 39 Yirmiyahu St., POBox 1176, Jerusalem, 9446724, Israel, Email: alexpon8@gmail.com Received: November 04, 2014; Accepted: November 13, 2014; Published: November 18, 2014