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Negative Symptoms Revisited

Daniel P. van Kammen, MD, PhD; Jeffrey Peters, MD; Jeffrey Yao, PhD; Welmoet B. van Kammen, PhD; Thomas Neylan, MD; David Shaw, PhD; Markku Linnoila, MD, PhD

Arch Gen Psychiatry. 1990;47(2):161-168.

Abstract
• In recent years the dopamine hypothesis has failed to explain the complexities of schizophrenia. Because both negative symptoms and noradrenergic activity appear to increase with psychotic relapse, we studied negative symptoms, psychosis, cerbrospinal fluid norepinephrine, and cerebrospinal fluid monoamine metabolites in 32 male patients with a DSM-III diagnosis of schizophrenia while both receiving and not receiving long-term haloperidol treatment. Drug-free cerebrospinal fluid norepinephrine and 3-methoxy-4-hydroxyphenylglycol levels correlated significantly with the severity of negative symptoms and psychosis ratings. When the patients were divided into those who did and did not relapse while not receiving the drug, significant positive correlations between negative symptoms and cerebrospinal fluid norepinephrine and 3-methoxy-4-hydroxyphenylglycol were observed only in the patients who relapsed. Nonsignificant but negative correlations were observed between the same variables in the nonrelapsers. Thus, increased norepinephrine activity in drug-free patients is associated with intensification of schizophrenic symptoms without necessarily causing the symptoms.

Author Affiliations
From the Western Psychiatric Institute and Clinic, University of Pittsburgh (Pa) Medical School, and Highland Drive Veterans Administration Medical Center, Pittsburgh (Drs D. P. van Kammen, Peters, Yao, W. B. van Kammen, Neylan, and Shaw); and the National Institute of Alcoholism and Alcohol Abuse, Bethesda, Md (Dr Linnoila).

Footnotes
Accepted for publication March 24, 1989.

Presented in part at the Negative Symptom Symposium at the 141st Annual Meeting of the American Psychiatric Association, Montreal, Canada, May 12, 1988.

Reprint requests to Highland Drive VA Medical Center, Pittsburgh, PA 15206 (Dr D. P. van Kammen).

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