This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A Critical Reappraisal

Nancy C. Andreasen, MD, PhD; Michael Flaum, MD; Victor W. Swayze II, MD; Gary Tyrrell, MS; Stephan Arndt, PhD

Arch Gen Psychiatry. 1990;47(7):615-621.

Abstract
• We reexamined the validity of subdividing schizophrenia into categorical subtypes using the predominance of positive and negative symptoms as the characteristic defining features. Using diagnostic criteria proposed in 1982, we again found that the negative subtype may be characterized by a variety of hypothesized correlates of structural brain abnormality, including poor premorbid adjustment, early age at onset, lower educational achievement, poor performance on cognitive testing, and poor response to treatment; a preponderance were also male and unemployed. The patients with negative symptoms did not have a significantly larger ventricular-brain ratio than did those with mixed or positive symptoms, however. As an alternative approach, patients were also classified by ventricle size (large and small); this classification had less predictive validity, with the use of hypothesized indexes of structural brain abnormality, than did the classification based on phenomenology.

Author Affiliations
From the Department of Psychiatry, University of Iowa College of Medicine, Iowa City.

Footnotes
Accepted for publication December 15, 1989.

Reprint requests to Department of Psychiatry, University of Iowa College of Medicine, 500 Newton Rd, Iowa City, IA 52242 (Dr Andreasen).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Lack of association between AKT1 variances versus clinical manifestations and social function in patients with schizophrenia
Liu et al.
J Psychopharmacol 2009;23:937-943.
ABSTRACT  

EEG Power Spectra Differentiate Positive and Negative Subgroups in Neuroleptic-Naive Schizophrenia Patients
John et al.
J. Neuropsychiatry Clin. Neurosi. 2009;21:160-172.
ABSTRACT | FULL TEXT  

Five-Year Follow-up of a Randomized Multicenter Trial of Intensive Early Intervention vs Standard Treatment for Patients With a First Episode of Psychotic Illness: The OPUS Trial
Bertelsen et al.
Arch Gen Psychiatry 2008;65:762-771.
ABSTRACT | FULL TEXT  

No Evidence of a Homogeneous Frontal Neuropsychological Profile in a Sample of Schizophrenic Subjects
Gambini et al.
J. Neuropsychiatry Clin. Neurosi. 2003;15:53-57.
ABSTRACT | FULL TEXT  

OPUS study: suicidal behaviour, suicidal ideation and hopelessness among patients with first-episode psychosis: One-year follow-up of a randomised controlled trial
NORDENTOFT et al.
Br. J. Psychiatry 2002;181 :s98-s106.
ABSTRACT | FULL TEXT  

Relationship Between Positive and Negative Symptoms of Schizophrenia and Schizotypal Symptoms in Nonpsychotic Relatives
Fanous et al.
Arch Gen Psychiatry 2001;58:669-673.
ABSTRACT | FULL TEXT  

Syndromic Validity of Apathy in Alzheimer's Disease
Starkstein et al.
Am. J. Psychiatry 2001;158:872-877.
ABSTRACT | FULL TEXT  

Rehabilitation Programmes and Quality of Life in Severe Mental Illness
Browne
Int J Soc Psychiatry 1999;45:302-309.
ABSTRACT  

Longitudinal Study of Cognitive Function in First-Episode and Recent-Onset Schizophrenia
Gold et al.
Am. J. Psychiatry 1999;156:1342-1348.
ABSTRACT | FULL TEXT  

Psychosis in Late Life: How Does It Fit Into Current Diagnostic Criteria?
Crespo-Facorro et al.
Am. J. Psychiatry 1999;156:624-629.
FULL TEXT  

Empirical Validation of Primary Negative Symptoms: Independence From Effects of Medication and Psychosis
Kelley et al.
Am. J. Psychiatry 1999;156:406-411.
ABSTRACT | FULL TEXT  

Treating Substance Abuse Among Patients With Schizophrenia
Bellack and DiClemente
Psychiatr. Serv. 1999;50:75-80.
ABSTRACT | FULL TEXT  

Clinical Correlates of Memory in Schizophrenia: Differential Links Between Depression, Positive and Negative Symptoms, and Two Types of Memory Impairment
Brebion et al.
Am. J. Psychiatry 1997;154:1538-1543.
ABSTRACT | FULL TEXT  

Symptoms of Schizophrenia: Methods, Meanings, and Mechanisms
Andreasen et al.
Arch Gen Psychiatry 1995;52:341-351.
ABSTRACT  

Signs and Symptoms: What Can They Tell Us About the Clinical Course and Pathophysiologic Processes of Schizophrenia?
Lieberman
Arch Gen Psychiatry 1995;52:361-363.
ABSTRACT  

Structure and Course of Positive and Negative Symptoms in Schizophrenia
Eaton et al.
Arch Gen Psychiatry 1995;52:127-134.
ABSTRACT  

Treatment of Abulia with Carbidopa/Levodopa
Drubach et al.
Neurorehabil Neural Repair 1995;9:151-155.
ABSTRACT  

Testing Systems for Assessment of Negative Symptoms in Schizophrenia
Fenton and McGlashan
Arch Gen Psychiatry 1992;49:179-184.
ABSTRACT  

The Positive-Negative Distinction in Schizophrenia: Review of Natural History Validators
McGlashan and Fenton
Arch Gen Psychiatry 1992;49:63-72.
ABSTRACT  

Natural History of Schizophrenia Subtypes: II. Positive and Negative Symptoms and Long-term Course
Fenton and McGlashan
Arch Gen Psychiatry 1991;48:978-986.
ABSTRACT