Negative, parkinsonian, depressive and catatonic symptoms in schizophrenia: a conflict of paradigms revisited

Background: To study the interrelationship pattern of negative, depressive, parkinsonian and catatonic symptoms over an exacerbation phase of schizoph renia. Method: Forty-five inpatients with a DSM-IV diagnosis of schizophren ia or schizophreniform disorder were assessed at admission and discharge fo r negative, depressive, parkinsonian and catatonic symptoms. A subsample of patients unmedicated at admission (n=23) was specifically analyzed. Result s: Negative, parkinsonian and catatonic symptoms correlated significantly a t both assessment points, as did their mean changes over the episode. At ad mission, depressive symptoms did not correlate with negative, parkinsonian or catatonic symptoms, but they did at discharge. Changes of depressive sym ptoms over the episode did not correlate with changes of the other groups o f symptoms. In the patients who were unmedicated at admission, ratings of n onakinetic parkinsonism, unlike ratings of akinetic parkinsonism, worsened significantly after neuroleptic treatment. Conclusions: While negative, par kinsonian and catatonic symptoms are highly related features, depressive sy mptoms seem to be a relatively independent dimension of psychopathology in schizophrenia. Non-akinetic parkinsonian symptoms may be more useful than t he akinetic symptoms in distinguishing primary from drug-induced negative s ymptoms. (C) 1999 Elsevier Science B.V. All rights reserved.