Evolution of the schizophrenic deficit concept

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The relevance of this study is the high prevalence and clinical heterogeneity of deficit states in chronic schizophrenia and schizophrenia spectrum disorders. The study aimed at analyzing negative symptoms in schizophrenia and schizophrenia spectrum disorders from historical and modern perspectives. An analysis of available literature, along with own observations, has been performed. It was found that negative symptoms comprise 3 clinical types: 1) «pseudopsychopathic» type (overlapping personality dimensions and premorbid/initial negative symptoms), 2) pseudoorganic/asthenic/pseudobradiphrenic type (pseudoorganic states), developing at different stages of schizophrenia), 3) «new»-life pseudopsychopathic type (not associated with premorbid personality traits), developing at late stages in schizophrenia. The trajectory heterogeneity of negative symptoms in their relation to positive symptoms has been defined: simultaneous-continuous course (synchronous course of positive and negative symptoms), polar course (alternative development of predominantly positive or negative symptoms), simultaneous-phasic course (pseudopsychopathic negative symptoms, attracting depressive symptoms, or depression that exacerbates latent deficit). The authors discuss some aspects of psychopharmacological treatment of negative symptoms. Negative symptoms in schizophrenia and schizophrenia spectrum disorders differ clinically, have heterogeneous trajectory course, and require differentiated approach with regard to psychopathological qualification, prognosis and treatment.

Keywords:

negative symptoms

schizophrenia

schizophrenia spectrum disorders

pseudopsychopathic deficit

pseudoorganic deficit

treatment of deficit symptoms

Authors:

Smulevich A.B.

Sechenov First Moscow State Medical University of Ministry of health of the Russia, Moscow, Russia

Romanov D.V.

FGBU "Nauchnyĭ tsentr psikhicheskogo zdorov'ia" RAMN, Moskva;
NOKTs "Psikhosomaticheskaia meditsina" Pervogo Moskovskogo gosudarstvennogo meditsinskogo universiteta im. I.M. Sechenova, Moskva

Voronova E.I.

Sechenov First Moscow State Medical University, Moscow

Mukhorina A.K.

Mental Health Research Center, Moscow, Russia

Chitlova V.V.

Tsentr psikhicheskogo zdorov'ia RAMN, Moskva

Sorokina O.Yu.

Mental Health Research Center, Moscow, Russia

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