Negative Symptoms in Schizophrenia: The Effect of Long-Term, Community-Based Psychiatric Intervention

Abstract

Negative symptoms in schizophrenia, a term going back to the last century [1], have been the subject of research interest on the part of a number of investigators, who have studied their etiology, prognostic value, and treatment [2-10]. Negative symptoms have been defined as deficit symptoms or impairment in functioning, the clinical picture being characterized by blunted, flat affect, psychomotor retardation, and poverty of speech [2-4]. Wing [11] considers the clinical poverty syndrome synonymous with chronic schizophrenia, in which these symptoms are present. Recent clinical research has provided evidence that negative symptoms do not constitute a bipolar continuum, but rather are part of a process of severe psychopathology and social dysfunction responding fairly poorly to antipsychotic medication. The latter finding, along with laboratory indices, has prompted some researchers to hypothesize that negative symptoms reflect structural brain deficits [4,10,12]. Despite the pessimism resulting from the poor prognosis of schizophrenic patients with negative symptoms, some investigators have shown that psychosocial intervention can predict a better social outcome of such patients [13]. A review of the recent literature on negative symptoms reveals a