The Deficit Syndrome of Schizophrenia: Towards Heterogeneity

Abstract

Since the turn of the century, psychiatrists have been concerned with both the unity and diversity of schizophrenia. From these early descriptions until now, many authors have attempted to delineate clinically meaningful subtypes within this disorder. In this connection, negative/positive subtyping has generated great interest. Carpenter and his team have emphasized the origin of the negative symptoms observed. They have proposed that primary enduring negative symptoms should be distinguished from transient negative symptoms resulting from treatment, depression or social deprivation and should be termed deficit symptoms. The validity of this subtyping is supported by clinical, biochemical or electrophysiological studies showing differences between deficit and nondeficit patients.

Symptom dimensions in the course of childhood-onset schizophrenia

“…An alternative conceptualization of schizophrenia is the symptom orientated dimensional approach (9,14,44). This research strategy has some advantages: More exact conclusions can be extended from symptom configurations to underlying biological and neuropsychological core deficits, clusters of homologous symptoms assessed over time may have a higher prognostic validity, and treatment effects can be described more precisely (e.g., the comparison of the efficacy of typical and atypical neuroleptics such as risperidone).…”