Negative Symptoms of Schizophrenia : Hard to detect and treat

BOSTON, MA — Hallucinations and delusions are the most obvious symptoms of schizophrenia. But such psychotic or "positive" symptoms are not necessarily the most important or disabling ones. Another set of symptoms, called "negative" symptoms, are much more pervasive and persistent—and they have a much greater effect on a patient's quality of life, reports the July issue of the Harvard Mental Health Letter.

Negative symptoms are marked by absence as much as presence: inexpressive faces, monotone speech, few gestures, seeming lack of interest in the world, and inability to feel pleasure. "Positive symptoms make treatment seem more urgent. But negative symptoms are the main reason patients with schizophrenia cannot live independently, hold jobs, establish personal relationships, and manage everyday social situations. These symptoms are also the ones that trouble them most," says Dr. Michael Miller, editor in chief of the Harvard Mental Health Letter.

Negative symptoms are closely related to limitations in cognitive abilities, such as mental flexibility and the capacity to pay attention and shift focus when necessary. Such mental limitations also affect real-world functioning and the outcome of the illness.

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