Year: 2019 | Month: January-March | Volume: 4 | Issue: 1 | Pages: 162-179
Negative Symptoms- an Update
Dr Pavithra P. Rao1, Dr Preethi Rebello2, Dr P. John Mathai3
1Assistant Professor, Department of Psychiatry. Father Muller Medical College, Mangalore, Karnataka, India.
2Senior Resident, Department of Psychiatry, Father Muller Medical College, Mangalore, Karnataka, India.
3Professor. Department of Psychiatry, Jubilee Mission Medical College, East Fort Thrissur. Kerala. India.
Corresponding Author: Dr P. John Mathai
Negative Symptoms in psychiatry are deficits in experience and behavior that are attributed to loss of functions of brain. Negative symptoms have been conceptualized as the core aspect of schizophrenia and have been recognized as important ever since the days of Griesinger, Kraepelin and Bleuler. But over the years the significance of the negative symptoms was deleted and emphasis was placed almost exclusively on positive symptoms. The return of negative symptoms in schizophrenia was inevitable. The five general categories of negative symptoms include avolition, anhedonia, affective blunting, alogia and asociality. The subdomains of negative symptoms are experience domain (avolition and anhedonia) and expressivity domain (affective blunting and alogia).
In this review article the authors discuss the evolution of the concept, the current conceptualization, consensus general categories and subdomains of negative symptoms, the relationships to symptoms of other domains, negative symptoms in the different phases of schizophrenia, Primary Enduring Negative Symptoms (PENS) and Persistent Negative Symptom (PNS), the nonspecific, specific and new generation scales for assessment. The clinical importance of negative symptoms in terms of diagnosis, prognosis and treatment options, the impact on comprehension of neurobiology of schizophrenia and the resultant modifications in clinical and etiological models of schizophrenia are discussed. Further the authors briefly discuss negative symptoms in other psychiatric disorders.
Key words: Negative Symptoms, Deficits, Core of Schizophrenia, Category, Sub-domain.