The Positive-Negative Distinction in Schizophrenia: Review of Natural History Validators

doi:10.1001/archpsyc.1992.01820010063008

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Vol. 49 No. 1, January 1992

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The Positive-Negative Distinction in Schizophrenia

Review of Natural History Validators

Thomas H. McGlashan, MD; Wayne S. Fenton, MD

Arch Gen Psychiatry. 1992;49(1):63-72.

Abstract

• A review of the interaction between the positive-negativesymptom distinction in schizophrenia and multiple measures ofillness natural history reveals some redundant and compellingpatterns. Negative or deficit symptoms are often associatedwith inferior social/instrumental functioning premorbidly, moreabnormal voluntary/involuntary movements at illness presentation,and poorer long-term outcome when present beyond the early phaseof illness. Negative symptoms are semi-independent of positivesymptoms. They are variable early in the illness but accruein severity, stability, and prognostic weight with time. Thenature of the processes that generate negative symptoms andtheir specificity to schizophrenia remain to be elucidated.Nevertheless, it is clear that negative symptoms are a commonand valid component of schizophrenia and deserve recognitionas such in our nosology.

Author Affiliations

From the Yale Psychiatric Institute, New Haven, Conn (Dr McGlashan), and the Chestnut Lodge Research Institute, Rockville, Md (Dr Fenton).

Footnotes

Accepted for publication March 4, 1991.

Reprint requests to Yale Psychiatric Institute, PO Box 12-A,Yale Station, New Haven, CT 06520 (Dr McGlashan).

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