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Smulevich A.B.

Sechenov First Moscow State Medical University (Sechenov University);
Mental Health Research Center

Klyushnik T.P.

Mental Health Research Center

Lobanova V.M.

Mental Health Research Center

Voronova E.I.

Sechenov First Moscow State Medical University (Sechenov University);
Mental Health Research Center

Negative and positive disorders of schizophrenia (issues of co-dependence, psychopathology and pathogenesis)

Authors:

Smulevich A.B., Klyushnik T.P., Lobanova V.M., Voronova E.I.

More about the authors

Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(6‑2): 13‑22

DOI: 10.17116/jnevro202012006213

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Smulevich AB, Klyushnik TP, Lobanova VM, Voronova EI. Negative and positive disorders of schizophrenia (issues of co-dependence, psychopathology and pathogenesis). S.S. Korsakov Journal of Neurology and Psychiatry. 2020;120(6‑2):13‑22. (In Russ.)
https://doi.org/10.17116/jnevro202012006213

 
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The authors consider current and own conceptions about correlations of the processes underlying the pathogenesis of schizophrenia presented by negative and positive disorders. With growth of academic psychiatry, evaluation of a correlation between positive and negative dimensions has changed dramatically: on the one hand presenting in clinical unity — simultaneous psychopathologic structures, and on the other hand being clinically and pathogenetically heterogenic in dimensional structure. According to our clinical and biological findings and an analysis of fundamental neurobiological studies, positive and negative disorders present in the clinical picture of schizophrenia as two separate psychopathological and pathogenetic structures. A new paradigm of the correlation between positive and negative structures — the interaction between positive and deficit symptoms — reveals psychopathological functions differentiated for each of dimensional structures. Negative disorders act as «transformers» modifying characteristics of primary transnosological positive disorders to the level of psychopathological structures preferable for schizophrenia; positive disorders, in their turn, act as «moderators» augmenting, amplifying manifestations of negative symptoms. This psychopathological construct of the correlation between dimensional structures paves a way for the development of a new concept of psychopharmacological treatment of schizophrenic deficit: both negative symptoms and amplifying positive symptoms are considered as «target symptoms» for pharmacological interventions.

Keywords:

schizophrenia
negative symptoms
positive symptoms
therapy

Authors:

Smulevich A.B.

Sechenov First Moscow State Medical University (Sechenov University);
Mental Health Research Center

Klyushnik T.P.

Mental Health Research Center

Lobanova V.M.

Mental Health Research Center

Voronova E.I.

Sechenov First Moscow State Medical University (Sechenov University);
Mental Health Research Center

Received:

13.04.2020

Accepted:

13.04.2020

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