Abstract
Recent research suggests the existence of at least two separable domains of negative symptoms in schizophrenia and related psychotic disorders. One of the domains reflects diminished expression including affective flattening and poverty of speech and the second consists of apathy as reflected in diminished motivation and social interest. It has been suggested that these domains may have different underlying etiologies and differ in their significance for recovery. There has been little investigation of the course of these two domains during treatment. We will present the results of a five year prospective study of the course of these negative symptom domains in 132 first episode patients who were followed from the initiation of treatment. Results show a significantly greater prevalence of the apathy domain than reduced expressiveness. When it occurred, apathy was also of longer duration than reduced expressiveness and showed stronger correlations with psychosocial functioning . Examination of the longitudinal course of each domain of negative symptoms revealed differences in temporal relationships other symptoms.
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