Positive and negative symptoms
Positive and negative symptoms are medical terms for two
groups of symptoms in schizophrenia.
Positive symptoms add. Positive symptoms include
hallucinations (sensations that aren’t real), delusions (beliefs that can’t be
real), and repetitive movements that are hard to control.
Negative symptoms take away. Negative symptoms include the
inability to show emotions, apathy, difficulties talking, and withdrawing from
social situations and relationships.
There is also a third group of symptoms, usually called cognitive
symptoms. This includes anything related to thinking, such as disorganized
thoughts, memory problems, and difficulties with focus and attention.
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Positive
and negative symptoms
Schizophrenia is frequently a chronic and disabling disorder,
characterized by heterogeneous positive and negative symptom constellations.
The objective of this review was to provide information that may be useful for
clinicians treating patients with negative symptoms of schizophrenia. Negative
symptoms are a core component of schizophrenia that account for a large part of
the long-term disability and poor functional outcomes in patients with the disorder.
The term negative symptoms describes a lessening or absence of normal behaviors
and functions related to motivation and interest, or verbal/emotional
expression. The negative symptom domain consists of five key constructs:
blunted affect, alogia (reduction in quantity of words spoken), avolition
(reduced goal-directed activity due to decreased motivation), asociality, and
anhedonia (reduced experience of pleasure).
Negative symptoms are common in schizophrenia; up to 60% of
patients may have prominent clinically relevant negative symptoms that require
treatment. Negative symptoms can occur at any point in the course of illness,
although they are reported as the most common first symptom of schizophrenia.
Negative symptoms can be primary symptoms, which are intrinsic to the
underlying pathophysiology of schizophrenia, or secondary symptoms that are
related to psychiatric or medical comorbidities, adverse effects of treatment,
or environmental factors. While secondary negative symptoms can improve as a consequence
of treatment to improve symptoms in other domains (ie, positive symptoms,
depressive symptoms or extrapyramidal symptoms), primary negative symptoms
generally do not respond well to currently available antipsychotic treatment
with dopamine D2 antagonists or partial D2 agonists.
Since some patients may lack insight about the presence of
negative symptoms, these are generally not the reason that patients seek
clinical care, and clinicians should be especially vigilant for their presence.
Negative symptoms clearly constitute an unmet medical need in schizophrenia,
and new and effective treatments are urgently needed.
Schizophrenia is frequently a chronic and disabling disorder,
characterized by heterogeneous positive and negative symptom constellations. The
distinction between positive and negative symptoms originated in the field of
neurology and was later adopted in psychiatry; in schizophrenia, this
distinction corresponds to clinical observations and allows the disorder to be
described in terms of symptom domains. While positive symptoms reflect an
excess or distortion of normal function (eg, delusions, hallucinations,
disorganized behavior),
negative symptoms refer to a diminution or absence of normal
behaviors related to motivation and interest (eg, avolition, anhedonia,
asociality) or expression (eg, blunted affect, alogia). Negative symptoms are a
core component of schizophrenia and they account for a large part of the
long-term morbidity and poor functional outcome in patients with the disorder. Associated
with significant deficiencies in motivation, communication, affect, and social
functioning, negative symptoms are a multifaceted concept with dimensions that
may have different impacts on functional outcomes.
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Borderline Personality Disorder
IMPORTANT QUESTIONS:-
i.Social-Occupational Dysfunction: Impairment in one of the major areas of functioning for a significant period of time since the onset of the disturbance: Work, interpersonal relations, or self-care
ii.Substance/General Medical Condition Exclusion: the effects of a substance or another medical condition do not cause the disturbance.
iii.Schizoaffective and Major Mood Disorder Exclusion: Schizoaffective disorder and bipolar or depressive disorder with psychotic features have been ruled out.
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