Positive and Negative Symptoms in Psychiatry

1986 ◽  
Vol 148 (5) ◽  
pp. 587-589 ◽  
Author(s):  
Michael R. Trimble
Keyword(s):  
Negative Symptoms ◽  
Geographical Location ◽  
Personal Communication ◽  
Thought Disorder ◽  
Positive Symptom ◽  
Positive Symptoms ◽  
Market Research Company ◽  
Research Company ◽  
Schizophrenic Patients ◽  
Positive And Negative Symptoms

The terms positive and negative symptoms have slipped into the language of contemporary psychiatry with comparative ease. It is not uncommon for these expressions to be used with little explanation, both at meeting and in written communications, with the implicit understanding that their meaning is understood and that somehow they are of value to our knowledge of psychopathology. However, that there are no clear guide-lines at present for our use of these terms is shown from a recent survey of psychiatrists' opinions from a market research company (Martin Hamblin Research-Personal Communication). As part of a series of questions asked to many psychiatrists of differing age, geographical location, and status, they were asked about the meaning of these terms, positive and negative symptoms and the proportion of schizophrenic patients having them. Of the categories quoted by Crow (1980–81) as positive symptoms, 68% considered that delusions were positive symptoms, 63% hallucinations, and only 35% thought disorder. In contrast, 18% thought that behaviour disturbance was a positive symptom, a similar figure (15%) being given for passivity feelings. Considerable variation was noted, however, with hallucinations being considered positive by only 33% of London psychiatrists, thought disorder by only 11% of those qualified 16–25 years, and one-quarter of all registrars and psychiatrists from Midland Health Districts considered passivity feelings to fall into this category. Even greater disagreement was recorded for negative symptoms. Thus, the symptom most often associated with this category was apathy, by 52% of respondents. Only 26% considered that withdrawal was a negative symptom, the percentage data for lack of motivation and blunting of affect being 37% and 15% respectively.

Negative Symptoms at Discharge and Outcome in Schizophrenia

1995 ◽  
Vol 166 (1) ◽  
pp. 61-67 ◽  
Author(s):  
Hai-Gwo Hwu ◽  
Happy Tan ◽  
Chu-Chang Chen ◽  
Ling-Ling Yeh
Keyword(s):  
Clinical Outcome ◽  
Social Functioning ◽  
Symptom Score ◽  
Negative Symptoms ◽  
Positive Symptom ◽  
Positive Symptoms ◽  
Symptom Scores ◽  
Schizophrenic Patients ◽  
Positive And Negative Symptoms

BackgroundThe clinical significance in schizophrenia of positive and negative symptoms at discharge was assessed.MethodOf schizophrenic patients fulfilling DSM–III criteria, 113 were recruited for this study. Personal, social and psychopathological data were collected and all cases were followed up at one and two years after discharge.ResultsThe presence of positive symptoms (64 cases), without concomitant negative symptoms, did not predict the follow-up social function and positive symptom score. Conversely, the presence of negative symptoms (31 cases) predicted worse social functioning (P < 0.05 to P < 0.005) and higher positive symptom scores (P < 0.01) at follow-up using MANOVA. Eighteen cases (15.9%) had neither positive nor negative symptoms and had the best clinical outcome.ConclusionsNegative, but not positive, symptoms assessed at discharge are an important predictor of poor outcome. In addition, negative symptoms may themselves expose a biological vulnerability to the presence of positive symptoms.

The Positive: Negative Dichotomy in Schizophrenia

1990 ◽  
Vol 157 (1) ◽  
pp. 41-49 ◽  
Author(s):  
A. M. Mortimer ◽  
C. E. Lund ◽  
P. J. McKenna
Keyword(s):  
Cognitive Impairment ◽  
Negative Symptom ◽  
Negative Symptoms ◽  
Thought Disorder ◽  
Motor Disorder ◽  
Positive Symptoms ◽  
Formal Thought Disorder ◽  
Symptom Scores ◽  
Schizophrenic Patients ◽  
Positive And Negative Symptoms

Two studies are reported. In the first, of 62 schizophrenic patients, no correlation between negative symptom scores (rated blindly) and any measure of positive symptoms was found. This independence was confirmed by factor and cluster analyses, which left the question of a third ‘disorganisation’ class of schizophrenic symptoms open. In the second study, of 80 patients, formal thought disorder separated unequivocally into ‘positive formal thought disorder’ and ‘alogia’ syndromes on the basis of correlations with positive and negative symptoms. Catatonic motor disorder also showed evidence of a corresponding positive: negative division, although this only emerged when severity or chronicity of illness was controlled for. Cognitive impairment showed a broad range of affiliations and its particular correlation with negative symptoms was perhaps artefactual.

Tardive Dyskinesia and Type II Schizophrenia

1992 ◽  
Vol 160 (2) ◽  
pp. 253-256 ◽  
Author(s):  
Elizabeth J. B. Davis ◽  
Milind Borde ◽  
L. N. Sharma
Keyword(s):  
Cognitive Impairment ◽  
Negative Symptoms ◽  
Chronic Schizophrenia ◽  
Thought Disorder ◽  
Control Group ◽  
Positive Symptoms ◽  
Type Ii ◽  
Formal Thought Disorder ◽  
Schizophrenic Patients ◽  
Male Patients

Cognitive impairment, negative and positive symptoms, primitive release reflexes, and age/temporal disorientation were assessed in 20 male patients meeting the DSM–III–R criteria for chronic schizophrenia and Schooler & Kane's criteria for TD. The control group comprised 20 age-matched male chronic schizophrenic patients without TD. Significant associations were found between TD, cognitive impairment, some negative symptoms, and formal thought disorder. These associations were independent of other illness and treatment variables. The severity of TD correlated significantly with that of cognitive impairment.

The Assessment of Negative and Positive Features in Schizophrenia

1989 ◽  
Vol 155 (S7) ◽  
pp. 41-44 ◽  
Author(s):  
Eve C. Johnstone
Keyword(s):  
Negative Symptoms ◽  
Normal Function ◽  
Thought Disorder ◽  
List Type ◽  
Type Number ◽  
Formal Thought Disorder ◽  
Clinical Correlates ◽  
Schizophrenic Patients ◽  
The Relationship ◽  
Positive And Negative Symptoms

It has become customary to classify the typical abnormalities of the mental state of schizophrenic patients into positive and negative features, with reference to behavioural excesses and deficits. Positive features are pathological by their presence and negative features represent the loss of some normal function. Positive features are generally considered to include delusions, hallucinations and positive formal thought disorder (Fish, 1962). Some studies (e.g. Johnstone et al, 1978) have also included incongruity of affect under this heading. Negative features include affective flattening, poverty of speech, retardation, apathy, lack of sociability. There is some evidence that the clinical correlates of positive and negative features may not be the same (Owens & Johnstone, 1980). Some workers (Andreasen & Olsen, 1982) but not others (Pogue-Geile & Harrow, 1984) have found that among schizophrenic patients positive and negative symptoms were negatively correlated. Although the nature of the relationship between positive and negative features is not entirely established and may not be simple (Wing, 1978) certain generalisations may be applied: (a)Positive features are characteristic of earlier and negative of later phases of the illness (Pfohl & Winokur, 1982).(b)The effects of drugs upon positive features are greater than those upon negative features. Thus neuroleptics produce more marked improvement (Johnstone et al, 1978; Angrist et al, 1980) and amphetamine more marked exacerbation (Angrist et al, 1980) of positive than of negative features.(c)Positive features have been said to be relatively variable and negative features relatively stable (Ovchinnikov, 1968; Snezhnevsky, 1968).

Duration of illness and structure of symptoms in schizophrenia

1999 ◽  
Vol 29 (4) ◽  
pp. 915-924 ◽  
Author(s):  
RAMIN MOJTABAI
Keyword(s):  
Negative Symptoms ◽  
Average Duration ◽  
Meta Analysis ◽  
Positive Symptom ◽  
Positive Symptoms ◽  
Cross Sectional ◽  
Pair Correlations ◽  
Duration Of Illness ◽  
Schizophrenic Patients ◽  
Sectional Structure

Background. Previous research has mainly focused on the cross-sectional structure of symptoms in schizophrenia. This meta-analysis examined the association of duration of illness with the structure of symptoms.Methods. Using explicit criteria, 22 studies reporting on the correlations of symptoms in 2665 schizophrenic patients were selected. From each study, symptom-pair correlations for negative symptoms as rated by Scale for the Assessment of Negative Symptoms (SANS) and positive symptoms as rated by the Scale for the Assessment of Positive Symptoms (SAPS) were extracted. Variability among symptom-pair correlations across studies was assessed using tests of homogeneity. For symptom-pair correlations which were not found to be homogeneous, the association of average duration of illness with the symptom-pair correlations were examined.Results. There was considerable variability in symptom-pair correlations across studies. Part of this variability was explainable by variations in average duration of illness. Longer duration of illness was associated with lower negative–negative symptom-pair correlations and higher negative–positive symptom-pair correlations.Conclusions. The findings suggest that the structure of symptoms in schizophrenia evolves over time, following a consistent pattern. In the early stages of illness, negative and positive symptoms form cohesive dimensions. With time, these dimensions become less cohesive and the boundaries between them, less clear.

scholarly journals Comparison of therapeutic effects of monotherapy of chlorpromazine, risperidone and their combination in newly diagnosed schizophrenic patients

2018 ◽  
Vol 7 (7) ◽  
pp. 1273
Author(s):  
Tarun Vijaywargia
Keyword(s):  
Negative Symptoms ◽  
Positive Symptom ◽  
Therapeutic Effects ◽  
Positive Symptoms ◽  
Newly Diagnosed ◽  
Anti Psychotic ◽  
Double Blind ◽  
Oral Risperidone ◽  
Beneficial Effects ◽  
Schizophrenic Patients

Background: This study evaluates and compares how negative and positive symptoms of schizophrenia were influenced with monotherapy with a first-generation anti-psychotic medication (Chlorpromazine) and a second generation anti-psychotic medication (Risperidone) and by their combination, both of which are commonly used in clinical psychiatric practice.Methods: It was randomized, double-blind, controlled clinical study performed in Indian newly diagnosed schizophrenic patients in the Department of psychiatry from Feb 2003 to March 2004. Patients 18 (eighteen) patients aged 20 to 60 years diagnosed schizophrenics according to ICD-10 Criteria who visited in outpatient department of psychiatry during study period. Three groups of 6 Patient each, group-1 - was treated with oral Chlorpromazine 100 mg 12 hly, group -2 - was treated with oral Risperidone 2mg 12 hly group 3 -was treated with combination of oral Chlorpromazine 100mg 12 hly + oral Risperidone 2 mg 12 hly. How symptomatology in schizophrenic patients affected, is measured by applying various validated psychiatric scales like Brief psychiatric Rating Score (BPRS), Scale for assessment of positive symptom(SAPS), and Scale for Assessment of Negative Symptoms (SANS).Results: the study showed that the combination therapy of oral Chlorpromazine 100 mg 12 hly + Risperidone 2mg 12 hly had reduced the overall beneficial effects which were achieved with monotherapy of both the drugs.Conclusions: In this study, the therapeutic effects of combination of oral Chlorpromazine 100 mg 12 hly + Risperidone 2 mg 12 hly found to be reduced on positive symptoms and negative symptoms of schizophrenia, assessed on SAPS and SANS scoring scales when compared with beneficial effects which were achieved with monotherapy of both the drugs.

Do positive symptom and negative symptom subtypes of schizophrenia show qualitative differences in language production?

1983 ◽  
Vol 13 (4) ◽  
pp. 787-797 ◽  
Author(s):  
Heidelinde A. Allen
Keyword(s):  
Negative Symptom ◽  
Language Production ◽  
Negative Symptoms ◽  
Speech Disorder ◽  
Positive Symptom ◽  
Positive Symptoms ◽  
Formal Thought Disorder ◽  
Chronic Schizophrenics ◽  
Prominent Symptom ◽  
Positive And Negative Symptoms

SynopsisThe present study examined a prominent symptom subtype conception of the psychopathology of schizophrenia. It analysed the presumed dichotomy between hallucinations, delusions and formal thought disorder as positive symptoms and flattening of affect and poverty of speech as negative symptoms, and tested predictions concerning the nature of the mediating processes of positive and negative symptoms. Four different analyses were applied to the transcripts of speech produced by 9 normals, 10 chronic schizophrenics with only positive symptoms of whom 7 had incoherence of speech, and 9 chronic schizophrenics with only negative symptoms of whom 4 had poverty of speech. The conception of the nature of the mediating processes of positive and negative symptoms was not supported by the results. Further, a clear dichotomy between positive and negative symptom groups was not shown to exist, because positive speech disorder and negative speech disorder did not follow the presupposed dichotomy. Thus, contrary to existing conceptions of speech disorder in schizophrenia, both positive and negative speech disorder are marked by poverty of thought, as measured by the production of fewer and shorter ideas and lower speech variability.

The Distinction of Positive and Negative Symptoms

1991 ◽  
Vol 158 (3) ◽  
pp. 317-322 ◽  
Author(s):  
Stephan Arndt ◽  
Randall J. Alliger ◽  
Nancy C. Andreasen
Keyword(s):  
Factor Analysis ◽  
Negative Symptoms ◽  
Two Dimensions ◽  
Previous Literature ◽  
Positive Symptom ◽  
Schizophrenic Patients ◽  
Pooled Sample ◽  
Positive And Negative Symptoms

The distinction of positive and negative symptoms in describing schizophrenic patients has become popular. It presupposes that symptoms cluster in two dimensions, fitting together not only theoretically but empirically. Factor analysis of three published studies of 93, 62 and 52 schizophrenic patients and a large pooled sample showed that more than two distinct dimensions are required to categorise symptoms in schizophrenia. This result is consistent across methods and samples, and with previous literature. The added dimensionality resulted from a splitting of the positive symptom domain into more distinct factors.

Positive and Negative Symptom Course in Chronic Community-Based Patients

1995 ◽  
Vol 166 (5) ◽  
pp. 634-641 ◽  
Author(s):  
Donald M. Quinlan ◽  
David Schuldberg ◽  
Hal Morgenstern ◽  
William Glazer
Keyword(s):  
Maintenance Treatment ◽  
Negative Symptoms ◽  
Positive Symptoms ◽  
Community Based ◽  
Symptom Profile ◽  
Schizophrenic Patients ◽  
Positive And Negative Symptoms ◽  
Over Time

BackgroundThe long-term symptom profile of chronic out-patients was studied.Method. 242 out-patients receiving neuroleptic medications (109 with schizophrenia and 133 non-schizophrenics), were studied for positive (SAPS) and negative (SANS) symptoms at baseline and at 24 months to investigate whether these symptom groups changed over out-patient maintenance treatment.ResultsOverall and within groups, negative symptoms decreased and positive symptoms increased. While the sums of the SANS scores for the schizophrenic patients were initially higher, their mean SANS score dropped more over time (P< 0.001), to show no difference from non-schizophrenics at follow-up. Positive symptoms increased in both groups, although schizophrenics were higher at both times; sub-scales within the SANS showed different patterns of change.ConclusionSupport is found for a multidimensional view of both positive and negative symptoms and for a reconsideration of the notion of ‘progressive downward course’ in schizophrenia.

The positive and negative symptoms of schizophrenia reflect impairments in the perception and initiation of action

1987 ◽  
Vol 17 (3) ◽  
pp. 631-648 ◽  
Author(s):  
C. D. Frith
Keyword(s):  
Negative Symptoms ◽  
Positive Symptoms ◽  
Type I ◽  
Type Ii ◽  
Chronic Patients ◽  
External Stimulation ◽  
Frontal Lobe Lesions ◽  
Schizophrenic Patients ◽  
External Stimuli ◽  
Positive And Negative Symptoms

SynopsisThe CNS maintains a fundamental distinction between actions elicited by external stimuli and actions elicited by internal goals (acts of will). As a result the intact organism can monitor centrally three aspects of its own actions: (1) the action appropriate to current external stimulation (stimulus intention or meaning); (2) the action appropriate to current goals (willed intention); and (3) the action which was actually selected (corollary discharge). In Type I (acute) schizophrenic patients, intentions of will lead to actions, but these willed intentions are not monitored correctly. This apparent discrepancy between will and action gives rise to experiential (1st rank) positive symptoms (e.g. delusions of control and passivity). In Type II (chronic) patients, intentions of will are no longer properly formed and so actions are rarely elicited via this route. This gives rise to behavioural negative signs (e.g. poverty of speech).The behaviour of Type II schizophrenics has surface similarities to that shown by patients with Parkinson's disease and patients with frontal lobe lesions in that all three types of patient show a relative deficit of actions elicited by willed intentions. Dopamine blocking drugs reduce positive symptoms in Type I patients precisely because they induce Parkinsonism, i.e. reduce the likelihood of actions being initiated by willed intentions. This in turn reduces the likelihood that actions will occur for which the patient had no awareness of his intention to act.

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