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).

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.

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.

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.

Conceptual Structure in Thought-Disordered Schizophrenics

1960 ◽  
Vol 106 (445) ◽  
pp. 1230-1249 ◽  
Author(s):  
D. Bannister
Keyword(s):  
Clinical Observation ◽  
Conceptual Structure ◽  
Thought Disorder ◽  
List Type ◽  
Type Number ◽  
Symbolic Meanings ◽  
Schizophrenic Patients

“Thought-disorder” in schizophrenia was initially a psychiatric concept derived from clinical observation. As crystallized in standard psychiatric authorities, say Mayer-Gross, Slater and Roth (1954) the primary features of the talk (and inferentially the thinking) of thought-disordered schizophrenic patients are: (i)Inconsequential following of side issues.(ii)Tendencies for the thought to be directed by alliterations, analogies, clang associations, associations with accidents of the speaker's environment, symbolic meanings, and the condensation of several (perhaps mutually contradictory) ideas into one.(iii)Words used out of context, e.g. concrete meanings taken where abstract meanings would be appropriate.(iv)Clinging to unimportant detail.(v)The use of laconic answers, e.g. I don't know, maybe, perhaps—indicative of emptiness and vagueness of ideas.(vi)Thought is generally marked by gaps, poverty, indefiniteness and vagueness.(vii)Indications of thought-blocking.(viii)Indications of pressure of thoughts.

Formal Thought Disorder and Semantic Memory in Schizophrenia

CNS Spectrums ◽  
1997 ◽  
Vol 2 (8) ◽  
pp. 15-25 ◽  
Author(s):  
Brita Elvevåg ◽  
Terry E. Goldberg
Keyword(s):  
Working Memory ◽  
Semantic Memory ◽  
Language Processing ◽  
Thought Disorder ◽  
Cognitive Mechanisms ◽  
Formal Thought Disorder ◽  
Schizophrenic Patients ◽  
Relationship Of ◽  
The Relationship ◽  
Insight Into

AbstractIn this article, we review attempts to account for the thought disorder present in some schizophrenic patients in terms of cognitive deficits in the domains of working memory, attention, language, and semantic memory. Although each psychological construct can account for some of the data described here, establishment of a primary cognitive impairment responsible for thought disorder is not forthcoming, perhaps due to its underlying multidimensional pathology. While the relationship of working memory, attention, and language processing to thought disorder is ambiguous, semantic memory is emerging as a promising construct, that may yield insight into cognitive mechanisms that underlie thought disorder and neuroleptic responsiveness.

Conceptual disorganization and redistribution of resting state cortical hubs in untreated first episode psychosis: A 7T MRI study

2020 ◽  
Author(s):  
Avyarthana Dey ◽  
Kara Dempster ◽  
Michael Mackinley ◽  
Peter Jeon ◽  
Tushar Das ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Superior Temporal Gyrus ◽  
Brain Regions ◽  
First Episode Psychosis ◽  
Cortical Reorganization ◽  
First Episode ◽  
Formal Thought Disorder ◽  
Whole Brain ◽  
Episode Psychosis ◽  
Positive And Negative Symptoms

Background:Network level dysconnectivity has been studied in positive and negative symptoms of schizophrenia. Conceptual disorganization (CD) is a symptom subtype which predicts impaired real-world functioning in psychosis. Systematic reviews have reported aberrant connectivity in formal thought disorder, a construct related to CD. However, no studies have investigated whole-brain functional correlates of CD in psychosis. We sought to investigate brain regions explaining the severity of CD in patients with first-episode psychosis (FEPs) compared with healthy controls (HCs).Methods:We computed whole-brain binarized degree centrality maps of 31 FEPs, 25 HCs and characterized the patterns of network connectivity in the two groups. In FEPs, we related these findings to the severity of CD. We also studied the effect of positive and negative symptoms on altered network connectivity.Results:Compared to HCs, reduced hubness of a right superior temporal gyrus (rSTG) cluster was observed in the FEPs. In patients exhibiting high CD, increased hubness of a medial superior parietal (mSPL) cluster was observed, compared to patients exhibiting low CD. These two regions were strongly correlated with CD scores but not with other symptom scores.Discussion:Our observations are congruent with previous findings of reduced but not increased hubness. We observed increased hubness of mSPL suggesting that cortical reorganization occurs to provide alternate routes for information transfer.Conclusion:These findings provide insight into the underlying neural processes mediating the presentation of symptoms in untreated FEP. A longitudinal tracking of the symptom course will be useful to assess the mechanisms underlying these compensatory changes.

Evaluation of positive and negative symptoms in schizophrenia

1986 ◽  
Vol 1 (2) ◽  
pp. 108-122 ◽  
Author(s):  
Nancy C. Andreasen ◽  
William M. Grove
Keyword(s):  
Negative Symptoms ◽  
The United States ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
University Of Iowa ◽  
Normal Functions ◽  
Subsequent Investigation ◽  
The University ◽  
The Relationship ◽  
Positive And Negative Symptoms

SummaryMost investigators concur that schizophrenia is probably a heterogeneous group of disorders that share the common features of psychotic symptoms, partial response to neuroleptics, and a relatively poor outcome. The subdivision of schizophrenia into two subtypes, positive versus negative, has achieved wide acceptance throughout the world during recent years. This distinction has heuristic and theoretical appeal because it unites phenomenology, pathophysiology, and etiology into a single comprehensive hypothesis.In spite of its wide appeal, the distinction has a number of problems. These include the failure to distinguish between symptom syndromes and diseases; failure to deal with the mixed patient; failure to take longitudinal course into account; and failure to address conceptually and methodologically the distinction between positive and negative symptoms.This paper focuses primarily on the conceptual basis for two instruments designed to measure positive and negative symptoms, the Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS), originally described in 1982. Since their description, these scales have been used in a variety of other centers. These scales are based on the hypothesis that negative symptoms represent a deficit or diminution in normal psychological functions wliile positive symptoms represent an excess or distortion of normal functions. Reliability data are now available from Italy, Spain, and Japan which suggest that these scales can be used reliably in cultural settings outside the United States. The results of these studies are summarized in this paper. In addition, a replication study involving a new sample of 117 schizophrenics collected at the University of Iowa is described. In this second study of the SANS and SAPS, internal consistency is found to be quite high in the SANS. Thus negative symptoms appear to be more internally correlated with one another than are positive symptoms. The implications of this result are discussed. A principal components analysis is used to explore the relationship between positive and negative symptoms. While the study reported in 1982 suggested that positive and negative symptoms are negatively correlated, in the present study they appear to be uncorrelated. Overall, the results suggest that the SANS and SAPS are useful comprehensive instruments for the evaluation of positive and negative symptoms. The relationship between these symptoms and external validators such as cognitive functioning or CT scan abnormalities will be reported in a subsequent investigation.

scholarly journals Metabolic syndrome in psychiatry: advances in understanding and management

2014 ◽  
Vol 20 (2) ◽  
pp. 101-112 ◽  
Author(s):  
Cyrus S. H. Ho ◽  
Melvyn W. B. Zhang ◽  
Anselm Mak ◽  
Roger C. M. Ho
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Psychiatric Disorders ◽  
Psychiatric Patients ◽  
Learning Objectives ◽  
List Type ◽  
Type Number ◽  
Unhealthy Lifestyle ◽  
Definition Of ◽  
The Relationship

SummaryMetabolic syndrome comprises a number of cardiovascular risk factors that increase morbidity and mortality. The increase in incidence of the syndrome among psychiatric patients has been unanimously demonstrated in recent studies and it has become one of the greatest challenges in psychiatric practice. Besides the use of psychotropic drugs, factors such as genetic polymorphisms, inflammation, endocrinopathies and unhealthy lifestyle contribute to the association between metabolic syndrome and a number of psychiatric disorders. In this article, we review the current diagnostic criteria for metabolic syndrome and propose clinically useful guidelines for psychiatrists to identify and monitor patients who may have the syndrome. We also outline the relationship between metabolic syndrome and individual psychiatric disorders, and discuss advances in pharmacological treatment for the syndrome, such as metformin.LEARNING OBJECTIVES•Be familiar with the definition of metabolic syndrome and its parameters of measurement.•Appreciate how individual psychiatric disorders contribute to metabolic syndrome and vice versa.•Develop a framework for the prevention, screening and management of metabolic syndrome in psychiatric patients.

Predictors of outcome in first-episode schizophrenia over the first 4 years of illness

2008 ◽  
Vol 38 (8) ◽  
pp. 1141-1146 ◽  
Author(s):  
P. Whitty ◽  
M. Clarke ◽  
O. McTigue ◽  
S. Browne ◽  
M. Kamali ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
First Episode ◽  
Global Assessment Of Functioning ◽  
Methodological Issues ◽  
Course Of Illness ◽  
Dsm Iv ◽  
First Episode Schizophrenia ◽  
The Relationship ◽  
Positive And Negative Symptoms

BackgroundThe outcome of schizophrenia appears to be more favourable than once thought. However, methodological issues, including the reliance on diagnosis at first presentation have limited the validity of outcome studies to date.MethodWe conducted a first-episode follow-up study of 97 patients with DSM-IV schizophrenia over the first 4 years of illness. First presentation and follow-up assessments were compared using paired t tests and a forced-entry regression analysis was used to determine prognostic variables.ResultsThere were significant improvements in positive and negative symptoms and global assessment of functioning between first presentation and follow-up. At first presentation, fewer negative symptoms (t=−3.40, p<0.01), more years spent in education (t=3.25, p<0.01), and a shorter duration of untreated psychosis (DUP) (t=−2.77, p<0.01) significantly predicted a better outcome at follow-up.ConclusionsThe outcome of schizophrenia may not be as pessimistic as once thought and most patients did not display a downward deteriorating course of illness. This study supports the relationship between DUP and outcome beyond the early stages of illness.

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.

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