NEGATIVE SYMPTOMS AND AFFECTIVE DISTURBANCE IN SCHIZOPHRENIA AND RELATED DISORDERS

Objective: To review the data and discuss clinical recommendations for treating negative symptoms of schizophrenia. Negative symptoms (e.g., poverty of thought, affective blunting) have been regarded as part of schizophrenia since Kraepelin's early descriptions although they rema in a subject of controversy For example, it is unclear if negative sym ptoms are distinct from other psychiatric symptoms such as depression, or are in actuality depression within schizophrenia. Recent evidence suggests that negative symptoms ave independent of depression. Method: Factor analytic studies have suggested that a negative factor (loss o f affect, volition, poverty of thinking) may be distinguished from oth er components and is separable from a depression factor. Experimental use of vignettes have also been useful in the assessment of negative s ymptoms. A second controversial area is whether or not the presence or absence of affect is the fundamental issue separating schizophrenia f rom other psychoses Results: A continuum of psychosis has been hypothe sized, with unipolar psychotic depression at one pole and schizophreni a with defect state at the other. Within this proposed continuum, nega tive symptoms ave associated only with schizophrenia without affect an d with defect state schizophrenia. As such, variation in affect could be a primary determinant of the type of psychosis. Conclusion: It appe ars that negative symptoms are a distinct aspect of schizophrenia and may aid in our understanding of psychotic disorders.