POSITIVE AND NEGATIVE SYMPTOMS IN NEUROLEPTIC-FREE PSYCHOTIC INPATIENTS

Andreasen's scales for the assessment of positive (SAPS) and negative (SANS) symptoms and the Brief Psychiatric Rating Scale (BPRS) were adm inistered to a group of 70 neuroleptic-free psychotic inpatients. Indi vidual ratings from the SAPS and SANS, together with the 18-item BPRS, were examined to identify clusters of symptoms. The findings, consist ent with our previous studies using medicated patients, did not suppor t a simple positive-negative dichotomy. Independent syndromes represen ting negative symptoms and thought disorder were apparent, although wi thin the negative syndrome there were three related sub-syndromes of f lat affect, alogia and social dysfunctions. Hallucinations and delusio ns did not form a homogeneous group of symptoms. Paranoia emerged as a distinct syndrome, and the remaining symptoms could be subdivided int o hallucinations, grandiose delusions, and 'loss of boundary' delusion s (e.g., thought broadcasting, mind reading). These syndromes, with th e exception of loss of boundary delusions, which consisted of SAPS del usions alone, correspond to syndromes of psychosis identified by Lorr and his colleagues thirty years ago. It is concluded that the currentl y popular 'three syndrome' model does not adequately represent the div ersity of psychotic symptoms.