Treatment of Negative Symptoms
Schizophrenia BulletinPublished 1 January 1985
William T. Carpenter, Douglas W Heinrichs, Larry Alphs
Citations506
SJR quartileQ1
SJR score2.14
SNIP1.67
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
A discussion of the diagnosis and treatment of the various forms of secondary negative symptoms is followed by suggestions for future research in the treatment of deficit symptoms.
Abstract
The rational treatment of the negative symptoms of schizophrenia requires a careful differentiation of those secondary to a range of other factors and those that constitute enduring primary or deficit symptoms. Secondary negative symptoms are usually responsive to treatment of the underlying cause. In contrast, there is no intervention currently available with established efficacy in treating deficit symptoms. These distinctions serve to reduce the heterogeneity of negative symptoms. A discussion of the diagnosis and treatment of the various forms of secondary negative symptoms is followed by suggestions for future research in the treatment of deficit symptoms.
Keywords
PsychologyMedicineArts and Humanities
American Journal of Health-System PharmacyThe Pharmacological Basis of Therapeutics
8,242 Citations1976
Journal of the American Medical AssociationDementia Praecox or the Group of Schizophrenias
4,407 Citations1951Eugen Bleuler
Annals of Internal MedicineDementia Praecox and Paraphrenia.
2,922 Citations1972
"Dementia Praecox and Paraphrenia" (1919) was the book in which Kraepelin first presented his work on schizophrenia to the English-speaking world, and it was probably the most influential psychiatric text of the entire 20th century, and has now become rare.
Archives of General PsychiatryNegative v Positive Schizophrenia
2,008 Citations1982Nancy C. Andreasen
Criteria for dividing the schizophrenic syndrome into three subtypes was developed: positive, negative, and mixed schizophrenia, and significant differences were noted using external validators such as premorbid adjustment, indices of cognitive dysfunction, ventricular brain ratio, and course in hospital.
BMJMolecular pathology of schizophrenia: more than one disease process?
1,858 Citations1980T.J. Crow
In Florence showed some symptomatic improvement with only minor side effects, but this requires confirmation in a controlled trial, and another approach is based on the finding that suppressor lymphocyte activity is depressed during acute relapses in multiple sclerosis.
Schizophrenia BulletinThe Quality of Life Scale: An Instrument for Rating the Schizophrenic Deficit Syndrome
1,688 Citations1984Douglas W Heinrichs, Thomas E. Hanlon +1 more
The authors describe the Quality of Life Scale (QLS), a 21-item scale based on a semistructured interview designed to assess deficit symptoms and thereby fill an important gap in the range of instruments now available.
Behavioral and Brain SciencesNeuroleptics and operant behavior: The anhedonia hypothesis
1,023 Citations1982Roy A. Wise
Cambridge University Press eBooksInstitutionalism and Schizophrenia
827 Citations1970J Wing, Brown Gw
Acta Psychiatrica ScandinavicaA standardized psychiatric assessment scale for rating chronic psychotic patients
680 Citations1977M. Krawiecka, David Goldberg +1 more
Simple 5‐point scales are described together with the method used to study their reliability, the results of which are shown.
JAMAThe Transmission of Schizophrenia
662 Citations1969Marjorie C. Meehan
Seven papers are presented on genetics, including a critical review of the literature, three of twins, and a genealogic study in Iceland where genealogy could be traced for seven people.
Archives of General PsychiatryThe Prediction of Outcome in Schizophrenia
645 Citations1974John S. Strauss
Findings support the view that outcome is not a single process but is comprised of several semi-independent processes best conceptualized as open-linked systems and must be considered in understanding, evaluating, and treating the different areas of outcome disability in schizophrenia.
Archives of General PsychiatryDiagnosis in Schizophrenia and Manic-Depressive Illness
632 Citations1978Harrison G. Pope
It is concluded that most so-called schizophrenic symptoms, taken alone and in cross section, have remarkably little, if any, demonstrated validity in determining diagnosis, prognosis, or treatment response in psychosis.
Schizophrenia BulletinPart III. Speculations on the Processes That Underlie Schizophrenic Symptoms and Signs
575 Citations1974Jaine Strauss, W. T. Carpenter +1 more
Archives of General PsychiatryCerebral Glucography With Positron Tomography
534 Citations1982Monte S. Buchsbaum
Local cerebral uptake of deoxyglucose labeled with fluorine 18 was measured by positron-emission tomography in eight patients with schizophrenia and in six age-matched normal volunteers, indicating relatively lower glucose use than normal control subjects.
Physiology of Behavior
522 Citations1978Neil R. Carlson
SciencePossible Etiology of Schizophrenia: Progressive Damage to the Noradrenergic Reward System by 6-Hydroxydopamine
481 Citations1971Larry Stein, C. David Wise
Episodic or continuous formation of endogenous 6-hydroxydopamine in man as a result of a genetically determined enzymatic error could selectively damage the binding capacity and, eventually, the structural integrity of the noradrenergic reward mechanism.
Schizophrenia BulletinFamily Treatment of Adult Schizophrenic Patients: A Psycho-educational Approach
439 Citations1980Carol Anderson, Gerard E. Hogarty +1 more
A model of family intervention has been developed which attempts to diminish relapse rates of schizophrenic patients and reflects theoretical and research findings which suggest that certain patients have a "core psychological deficit" that might increase vulnerability to external stimuli.
American Journal of PsychiatryVentricular enlargement in schizophrenia: relationship to positive and negative symptoms
428 Citations1982Nancy C. Andreasen, Scott A. Olsen +2 more
It is suggested that combining a measure of brain structure with the clinical picture may provide a useful new approach to the classification of schizophrenia.
Archives of General PsychiatryAnteroposterior Gradients in Cerebral Glucose Use in Schizophrenia and Affective Disorders
370 Citations1984Monte S. Buchsbaum
Local cerebral uptake of deoxyglucose labeled with fluorine 18 was measured by positron emission tomography in patients with schizophrenia and patients with affective disorder, sharing a lack of diagnostic specificity with many biologic measures.
Archives of General PsychiatryAre There Pathognomonic Symptoms in Schizophrenia?
356 Citations1973William T. Carpenter
It was found that the first-rank symptoms (FRSs) occurred frequently enough in acute schizophrenia to have diagnostic applicability, but Schneider's system for identifying schizophrenia, while highly discriminating, leads to significant diagnostic errors if FRSs are regarded as pathognomonic.
Archives of General PsychiatryPostpsychotic Depression in Schizophrenia
346 Citations1976Thomas H. McGlashan
A review and reformulation of Postpsychotic depression is presented, finding that therapeutic perseverence purportedly can improve the patient's long-term prognosis, and the phenomenon itself may be favorable prognostic sign.
PsychopharmacologyDifferential effects of amphetamine and neuroleptics on negative Vs. positive symptoms in schizophrenia
343 Citations1980Burt Angrist, John Rotrosen +1 more
Positive symptoms of schizophrenia were diminished by neuroleptics and increased by amphetamine and accounted for most of the change seen in the total Brief Psychiatric Rating Scale (BPRS), and new ideas about the role of dopamine in schizophrenia are discussed.
Elsevier eBooksTHE FRONTAL LOBES AND THE REGULATION OF BEHAVIOR
273 Citations1973A. R. Luria
The comparison of records of normal subjects and of patients with a delusional form of schizophrenia subjected to special tasks is discussed, discussing the changes that develop in the frontal lobes of the brain during mental exercise.
Archives of General PsychiatryCentral Dopamine Turnover in Schizophrenic Syndromes
268 Citations1974Malcolm B. Bowers
If clinical schizophrenia is characterized by increased central dopaminergic transmission, this increased transmission is not associated with increased central HVA formation, as determined by the measurement of lumbar CSF HVA following probenecid.
Schizophrenia BulletinNegative and Positive Symptoms in Schizophrenia and Depression: A Followup
262 Citations1984Michael F. Pogue‐Geile, Martin Harrow
It is suggested that negative symptoms are important for a subgroup of schizophrenic patients during the early course of their disorder and that they have important correlates with specific aspects of role functioning.
The British Journal of PsychiatryThe Disabilities of Chronic Schizophrenia—their Nature and the Factors Contributing to their Development
254 Citations1980D. G. Cunningham Owens, Eve C. Johnstone
It is concluded that impairments of the four areas of the present state are likely to be an integral part of the disease.
Schizophrenia BulletinA Review and Critique of Social Skills Training With Schizophrenic Patients
227 Citations1980Charles J. Wallace, Christian J. Nelson +5 more
Research must be directed to determining the interaction between patient characteristics and training procedures as they affect outcome, and the scope of the procedures must be expanded if meaningful changes in patients' quality of life are to be effected.
Schizophrenia BulletinA Critical Review of Recent Adoption, Twin, and Family Studies of Schizophrenia: Behavioral Genetics Perspectives
222 Citations1976I. I. Gottesman, James Shields
This review deals with data from recent family, twin, and adoption studies of schizophrenia rather than with theoretical issues—data primarily selected because they provide grist for one or another genetically "powered" mills.
Proceedings of the National Academy of SciencesAntischizophrenic drugs of the diphenylbutylpiperidine type act as calcium channel antagonists.
218 Citations1983R J Gould, Kathryn M. Murphy +2 more
Diphenylbutylpiperidines differ from other neuroleptics in their ability to relieve negative symptoms of schizophrenia, such as emotional withdrawal, as well as the positive symptoms which respond to all neurolePTics.
Schizophrenia BulletinAssessment of Negative and Positive Symptoms in Schizophrenia
211 Citations1983R.R.J. Lewine, Louis Fogg +1 more
The Rasch model is applied to the development of scales for negative and positive symptoms in schizophrenia, and the pattern of interscale correlations supports the view that positive symptoms, cognitive-affective negative symptoms, and social withdrawal are independent of one another.
The British Journal of PsychiatryPositive and Negative Schizophrenic Symptoms and the Role of Dopamine
207 Citations1980Angus Mackay
Most contemporary research has shown that the presence of positive symptom atology is a singularly weak prognostic indi cator, and the most widely held neurochemical hypo thesis for schizophrenia suggests that the disease is associated with relative overactivity of central dopamine systems.
The Lancet15O POSITRON EMISSION TOMOGRAPHIC SCANNING IN PREDOMINANTLY NEVER-TREATED ACUTE SCHIZOPHRENIC PATIENTS
205 Citations1983GrahamP. Sheppard, Rahul Manchanda +5 more
Acta Psychiatrica ScandinavicaA LONG‐TERM FOLLOW‐UP STUDY OF SCHIZOPHRENIA: PSYCHIATRIC COURSE OF ILLNESS AND PROGNOSIS
192 Citations1975Gerd Huber, Gisela Gross +1 more
The principle of the basic reversibility of typical schizophrenic symptoms and the extensive irreversibility of the non‐characteristic defect is important for the psychopathological and social long‐term prognosis.
Journal of Mental ScienceRemarks on Evolution and Dissolution of the Nervous System
175 Citations1887J. Hughlings Jackson
American Journal of PsychiatryIntermittent medication for stable schizophrenic outpatients: an alternative to maintenance medication
170 Citations1982M I Herz, Herman V. Szymanski +1 more
Archives of General PsychiatryPositive and Negative Symptoms and Jackson
170 Citations1985Germán E. Berríos
The old distinction between positive and negative symptoms has of late been reclaimed to describe the symptomatology of schizophrenia.
Archives of General PsychiatryPrognostic Implications of Six Alternative Definitions of Schizophrenia
148 Citations1979R. E. Kendell
The ability of six different operational definitions of schizophrenia to identify prospectively patients whose eventual prognosis would be poor was studied using data from a six-year follow-up of a series of 134 patients with functional psychoses.
Psychiatry ResearchLateral ventricular enlargement associated with persistent unemployment and negative symptoms in both schizophrenia and bipolar disorder
146 Citations1984Godfrey D. Pearlson, David J. Garbacz +3 more
The ventricular-to-brain ratio was strongly associated with persistent unemployment and negative symptoms in both patient groups and previous findings of relative lateral ventricular enlargement in a proportion of schizophrenic and bipolar patients were replicated.
Schizophrenia BulletinEarly Intervention, Time-limited, Targeted Pharmacotherapy of Schizophrenia
140 Citations1983W. T. Carpenter, Douglas W Heinrichs
Preliminary experience suggests that control of schizophrenic symptomatology comparable to that obtained with maintenance drugs can be achieved with a marked reduction in medication use when the targeted strategy is applied in the context of a broad-based program of psychosocial intervention based on a comprehensive medical model.
Archives of General PsychiatryDevelopment and Prediction of Postpsychotic Depression in Neuroleptic-Treated Schizophrenics
138 Citations1982Michel R. Mandel
Depressed patients had a more chronic psychiatric history and, contrary to the hypothesis that depression is a favorable prognostic indicator, they were more likely to relapse.
American Journal of PsychiatryAn investigation of the postpsychotic depressive syndrome
135 Citations1976T. H. McGlashan, William T. Carpenter
The findings indicate that postpsychotic depression occurs commonly, especially in patients medicated during hospitalization; it is difficult to predict on the basis of the presenting clinical picture; it represents an already existing symptom comlex that remits more slowly than the acute psychosis; and it fails to predict a more favorable outcome for schizophrenia at one year.
Archives of General PsychiatryTreatment of Secondary Depression in Schizophrenia
131 Citations1979Brigitte A. Prusoff
The study concludes that the value of adding an antidepressant to the usual neuroleptic in the treatment of secondary depression in schizophrenia should be reviewed.
Archives of General PsychiatryUse of Antidepressant Drugs in Schizophrenia
123 Citations1978Samuel G. Siris
This review surveys the therapeutic efficacy of tricyclic antidepressants and monoamine oxidase inhibitors in schizophrenic patients and found that when the patients who demonstrated symptoms of clinical depression other than anergia were isolated from several of these studies, it was found that they constituted a subgroup that was often benefited by use of these combinations.
PubMedNeurologic features and psychopathology in schizophrenic disorders.
118 Citations1984Theo C. Manschreck, Donna Ames
The results indicate that neurologic (motor and sensory) disturbances occur with the highest frequency and severity in schizophrenic subjects, and anomalous laterality preferences also occur more frequently among schizophrenics and are associated with greater frequency of neurologic disturbance, formal thought disorder, and impaired cognitive performance.
American Journal of PsychiatrySymptoms and the genetics of schizophrenia: implications for diagnosis
110 Citations1984Robert H. Dworkin, Mark F. Lenzenweger
The data indicate that negative symptoms may be characteristic of schizophrenia in which there is a greater genetic component.
PsychopharmacologyThe effect of l-dopa on young patients with simple schizophrenia, treated with neuroleptic drugs
110 Citations1975Jes Gerlach, Kurt L�hdorf
Thirteen out of 18 young out-patients with simple schizophrenia under neuroleptic treatment completed a double-blind cross-over trial with Madopar® [l-Dopa + benserazid (a peripheral decarboxylase inhibitor)] and placebo, and l-DOPA was effective against emotional withdrawal, blunted affect, tendency to isolation and apathy.
Schizophrenia BulletinDiagnosis of Schizophrenia: A Critical Review of Current Diagnostic Systems
95 Citations1981Wayne S. Fenton, Loren R. Mosher +1 more
Clinicians and researchers alike are advised to exercise caution and openmindedness in their use of DSM-III, as there is as yet no evidence that its criteria for schizophrenia are either less arbitrary or better than those of other systems or DSM-II.
Schizophrenia BulletinInteractions Between Drug and Psychosocial Therapy in Schizophrenia
83 Citations1983Ian R. H. Falloon, R. P. Liberman
Findings that psychosocial treatments were not efficacious in the community management of schizophrenia are contrasted with promising recent data from psychossocial treatments aimed at reducing environmental stressors and promoting interpersonal competence.
The Journal of Nervous and Mental DiseaseNeurological Soft Signs and Psychopathology I. Findings in Schizophrenia
82 Citations1979Stephen M. Cox, Arnold M. Ludwig
Systematic, standardized evaluations for neurological soft signs indicated that schizophrenics, compared to other groups, showed significant increased presence of soft signs presumably related to frontal and parietal lobe dysfunction.
Psychological MedicineFamilial differences in schizophrenia with good and poor prognosis
78 Citations1971Michael McCabe, Richard C. Fowler +2 more
The families with poor prognosis contained significantly more schizophrenia, neurosis, and overall illness, but less affective disorder than the families with good prognosis.
American Journal of PsychiatryAnimal models of schizophrenia
78 Citations1981W. T. McKinney, Elaine C. Moran
The authors review some general issues concerning the development and use of animal models of schizophrenia and present a summary of the criteria necessary for validating models, and comment on the etiologic, phenomenologic, and treatment relevance of the various systems.
Schizophrenia BulletinThe Pharmacologic Treatment of Schizophrenia: A Progress Report
76 Citations1983S. R. Donaldson, Alan J. Gelenberg +1 more
The benzodiazepines, clonidine, and carbamazepine all merit more investigation as possible treatments for psychosis and the implications of differential treatment response among schizophrenic patients are discussed.
British Journal of Pharmacology and ChemotherapyETHOLOGICAL AND STATISTICAL ANALYSIS OF DRUG EFFECTS ON THE SOCIAL BEHAVIOUR OF LABORATORY RATS
73 Citations1965Adina Silverman
Ethology provides a way of observing animal behaviour with increasing precision, and allows quantitative descriptions to be made of animal behaviour in the wild as well as in the laboratory.
Psychosomatic MedicineChanges in Primate Social Behavior After Treatment with Alpha-Methyl-Para-Tyrosine
56 Citations1971Eugene Redmond, James W. Maas +2 more
Two subjects within a social group of nonhuman primates were treated with alpha‐methyl‐paratyrosine, an inhibitor of the synthesis of these catecholamines, and showed retarded motor activity and assumed withdrawn postures, similar to the depressive state as seen in man.
Cognitive Rehabilitation: Conceptualization and Intervention
52 Citations1982Lance E. Trexler
This chapter discusses the use of Electronic Games in Cognitive Rehabilitation, and the role of Video Games in Rehabilitation Settings, as well as some of the factors behind the development of these games.
Acta Psychiatrica ScandinavicaAntidepressant drugs in anergic schizophrenia: A DOUBLE‐BLIND CROSS‐OVER STUDY WITH MAPROTILINE AND PLACEBO
52 Citations1980J Waehrens, Jes Gerlach
It must be concluded that antidepressant drugs do not represent any therapeutic advance in the treatment of inactive schizophrenic patients receiving neuroleptics.
Schizophrenia BulletinSocial Dysfunction and Treatment Failure in Schizophrenia
47 Citations1982Carmi Schooler, Herbert Spohn
The development of successful treatment programs for schizophrenia may hinge upon learning more about the nature of and reasons for the schizophrenic's social dysfunction, as well as finding that intensive socioenvironmental therapies have adverse effects on schizophrenics.
Psychiatry ResearchLow dose fluphenazine decanoate in maintenance treatment of schizophrenia
44 Citations1979John M. Kane, Arthur Rifkin +6 more
The results suggest that lower doses of fluphenazine decanoate than those usually used may be effective in preventing psychotic relapse while keeping total cumulative dosage to a minimum.
The British Journal of PsychiatryPositive and Negative Symptoms and the Thematic Organisation of Schizophrenic Speech
44 Citations1984Heidelinde A. Allen
Results showed that positive and negative symptom schizophrenics did not differ in the control and restriction of thematic speech organisation; speech disordered schizophrenics, positive as well as negative, showed cognitive restriction, by producing fewer inferential ideas than non-speech disordered schizophreniaics.
Archives of General PsychiatryPrediction of Response to Phenothiazines in Schizophrenia
43 Citations1972Solomon C. Goldberg
An attempt to replicate findings of two earlier studies suggesting schizophrenics could be assigned, according to their pattern of presenting symptomatology, to that phenothiazine on which they are likely to improve most is reported.
American Journal of PsychiatryMethodologic standards for treatment outcome research in schizophrenia
38 Citations1981W. T. Carpenter, Douglas W Heinrichs +1 more
Increased attention to meaningfulness in outcome research will make the conclusions of this type of research more valuable, both from pragmatic and theoretical standpoints.
American Journal of PsychiatryImplications of the efficacy of thiothixene and a chlorpromazine- imipramine combination for depression in schizophrenia
35 Citations1983Robert E. Becker
Archives of General PsychiatryRole of Antidepressants and Neuroleptics in the Treatment of Depression
32 Citations1972George M. Simpson
The results suggest that antidepressants are the treatment of choice in the diagnosis of depression, but they are probably contraindicated in symptoms of depression.
Schizophrenia BulletinAffective Symptoms and the Diagnosis of Schizophrenia
31 Citations1979Thomas H. McGlashan, W. T. Carpenter
This work reasserts the time-honored observation that schizophrenic patients can be affectively disturubed and still be schizophrenic and presents arguments in favor of maintaining such cases within an ambiguous or uncertain category.
Schizophrenia BulletinA Strategy for Developing Novel Drugs for the Treatment of Schizophrenia
27 Citations1983Arnold J. Friedhoff
An attempt to develop new drugs to improve the efficiency of the down-regulative system of the dopaminergic system as an alternative to conventional drugs that block dopamine receptors.
Archives of General PsychiatryAmitriptyline-Perphenazine Interaction in Ambulatory Schizophrenic Patients
27 Citations1975Guy Chouinard
American Journal of PsychiatryEvaluation of an Amitriptyline-Perphenazine Combination in Chronic Schizophrenia
27 Citations1970Robert E. Becker
The author describes a controlled study of an amitriptyline-perphenazine combination given to 58 chronic schizophrenic patients and concludes that there is no evidence that supports using a perphenazine-amitriptYline combination.
PsychopharmacologyLong-term chlorpromazine in rhesus monkeys: Production of dyskinesias and changes in social behavior
26 Citations1980W. T. McKinney, Elaine C. Moran +2 more
Dyskinesias which share major features of human tardive dyskinesia can be produced in nonhuman primates by long-term CPZ treatment, and two striking ones, gravel mouth and hand gesture, persisted for 12 weeks after drug withdrawal.
The Journal of Nervous and Mental DiseasePrognosis as the Critical Variable in Classification of the Functional Psychoses
20 Citations1982William T. Carpenter, Joseph H. Stephens
The literature now suggests that chronicity in psychiatric illness breeds true and that symptom constellations breed true, and the taxing study design required to simultaneously study these two attributes of disease entities is warranted.
The Retraining of Frontal Lobe Dysfunction
16 Citations1982James Craine
The Management of Schizophrenia in the Community
13 Citations1985John Wing
The psychiatric hospitals, in both Britain and in the United States, went through a prolonged period in which patients experienced pauperism, neglect, institutionalism, restraint, and occasionally cruelty.
The Role for Psychodynamic Psychiatry in the Treatment of Schizophrenic Patients
8 Citations1980William T. Carpenter, Douglas W Heinrichs
Intensive interpersonal therapy of schizophrenia, based on principles of psychotherapeutic or phenomenologic exploration, interests many, but has been the purview of only a few.
…