3 SYNDROMES IN SCHIZOPHRENIA - VALIDITY IN YOUNG-PATIENTS WITH RECENT-ONSET OF ILLNESS

The heterogeneity of schizophrenia constitutes an impediment in the id entification of reliable biological markers of the illness and aetiolo gical factors. The two syndrome concept of the illness has proved a po werful stimulus in this endeavour. There is however evidence now to re gard this construct as inadequate and in need of refinement. Using a s ample of young patients with early onset of illness who fulfilled the Research Diagnostic Criteria for schizophrenia, we have shown that thr ee rather than two dimensions better describe the pathology of the ill ness. The results of factor analysis showed these syndromes, termed di sorganization, positive, and negative syndromes, to account for 65% of the total variance of the psychopathology of the disorder. The negati ve syndrome was associated with disturbed pre-morbid functioning while the disorganization syndrome bore significant association with early onset of illness, poorer socio-educational attainment, and impairment on neuropsychological tests, especially those designed to evaluate fro ntal lobe functioning. The positive syndrome was not associated with a ny of the assessed variables. These results provide strong support for the validity of the three-syndrome construct even among a sample of n on-institutionalized patients.