Primary enduring negative symptoms in schizophrenia and major depression

The Deficit Syndrome in Schizophrenic and Nonschizophrenic Patients: Preliminary Studies

“…Early literature also documented anecdotal observations about deterioration in affective patients [4,30], In summary, although correlations have been found, the predictive value of the DSM-III-R diagnostic groups remained low to pre dict the deficit syndrome in the individual case. Furthermore, the findings reported here may support the hypothesis that not only secondary negative symptoms but also the 58 Gcrbaldo/Philipp Deficit and Light Sensitivity in Schizophrenics and Nonschizophrenics primary enduring subtype are nosologically unspecific [19,31] and may be expected also in non-schizophrenics. Our results might be also in accord with more recent work reporting negative symp toms (as a whole group) in neurotic, manic, depressive, schizoafffective and nonpsychiat ric patients [7][8][9]32], Nevertheless, these studies did consider neither the primary/secondary nor the deficit/nondeficit dichoto mies.…”

“…For instance Pearlson et al [35] found correlations be tween negative symptoms and ventricle:brain ratio for both schizophrenic and bipolar pa tients. Therefore we think that at present there is no clinical reason for systematically excluding all nonschizophrenics from biologi cal and pharmacological [ 19] studies of deficit or negative syndromes. For instance, new sub stances being reported to ameliorate negative features (e.g.…”

“…Nevertheless, we recognize that these kinds of negative symptoms are rel atively rare in psychiatric populations avail able in the university clinics. A methodologi cal alternative to process negative symptoms has been proposed by Benkert and colleagues [19], considering negative symptoms as pri mary only when the patients have been neuro leptic free for at least 12 months and showing neither depression nor psychotic symptoms. Finally, precise information about the course [48,49] and the stage of the disorder may be also an important condition for adequate in terpretation and comparison of data about process, deficit and negative symptoms.…”

“…Also greater neurological and neuro physiological impairments [13], different pat terns of glucose metabolism [14] or pathology of the caudate [ 15] have been reported in defi cit patients. The deficit syndrome is a psychopathological process for which there is presently no known effective remedy [16, p. 444], Irrespective of methodological criti cisms about Carpenter's criteria [17,18] and some concern about their applicability [19] they are the only attempt to address the prob lem of primary vs. secondary negative symp toms and further developments need to take this distinction into consideration [17], To our knowledge, published works about nega tive symptoms in nonschizophrenics consider the negative symptoms as a whole, regardless of the primary/secondary and deficit/nondeficit distinctions. Since these distinctions have been suggested to be more relevant for prog nosis and to help identifying patients being more resistent to neuroleptic therapy [12,16,20], we studied them in psychiatric patients in a 5-year follow-up evaluation.…”

Individual Music Therapy for Mental Health Care Clients with Low Therapy Motivation: Multicentre Randomised Controlled Trial

“…We chose a measure of negative symptoms as this concept encompasses areas that are highly relevant for MT: the ability (or its absence) to express oneself emotionally (affective flattening), the ability to form and sustain satisfactory relationships (anhedonia/asociality) and general motivation (avolition/apathy). Although negative symptoms are usually associated with schizophrenia, there is evidence that they are relevant for other disorders as well, notably for affective disorders [33,34,35,36,37]. Negative symptoms in themselves are strongly predictive of a need for care, irrespective of the primary diagnosis or whether the negative symptoms are considered primary or secondary [38].…”