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Do Negative Symptoms Respond to Pharmacological Treatment?

Published online by Cambridge University Press:  06 August 2018

John M. Kane
Affiliation:
Department of Psychiatry, Hillside Hospital, Division of Long Island Jewish Medical Center, New York
David Mayerhoff
Affiliation:
Department of Psychiatry, Hillside Hospital, Division of Long Island Jewish Medical Center, New York

Extract

The introduction of neuroleptic (or anti-psychotic) medication into clinical practice was a major advance in the treatment of schizophrenia. Numerous well-controlled, double-blind clinical trials have established the therapeutic efficacy of these agents in both the acute and long-term treatment of schizophrenia (Klein et al, 1980; Kane & Lieberman, 1987). In general, the therapeutic benefit of medication has been assessed in terms of the relative reduction in the more florid signs and symptoms of schizophrenia (e.g. hallucinations, delusions, thought disorder, agitation, and hostility) and the ability of maintenance medication to reduce the rate of recurrence of these symptoms and in turn rates of rehospitalisation. At the same time it has been quite apparent that anti-psychotic drugs do not necessarily eliminate some of the major chronic disabilities of patients with this illness, disabilities reflected in impoverished affect, lack of drive and ambition, impaired spontaneity, reduced ability to relate to others, and diminished pleasure capacity. These symptoms have at times been described as negative in that they reflect an absence of or reduction in certain aspects of psychologic, cognitive, and emotional functioning in an attempt to distinguish them from the distortions or exaggerations in normal function which characterise positive symptoms (Strauss & Carpenter, 1974; Jackson, 1904).

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1989 

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