The historical evolution of the concept of negative symptoms in schizophrenia

Table IV schematically summarises the models of some important theoreticians in order to indicate the heterogeneity of the conceptual basis for the distinction between positive and negative forms of schizophrenia. Thus, in different terminologies, positive and negative symptoms by Reynolds and Jackson are related to different mental and somatic disturbances. Bleuler mainly judges associations and their possible alterations, particularly by affect. When Berze, through the insufficiency of mental activity, places a negative element into the centre of his schizophrenia theory, he is interested in the conscious mental acts and intentionality. Gruhle, on the other hand, considers the different activity of hyper- and hypo-phases and, as an additional dimension, the comprehensibility of motives. Janzarik, in his dynamistic conception, first of all analyses the positive and negative conditions from the viewpoint of energy and emotion. This simple review advises caution when composing historical positions to a unitarian concept of positive and negative psychoses. Considering the present discussion, however, we find a similar situation with quite different areas, which serve as support for the division into a positive and negative form of schizophrenia. The logic of these tendencies corresponds with the present trend to a multiaxial or multidimensional registration of clinical, psychopathological and biological data. However, the various levels of explanation have questionable relations to each other. According to the clinical model based on natural sciences, we expect an approach to valid entities by an optimisation of the defining criteria which are derived from psychological, somatological and clinical sources (Sass, 1987).(ABSTRACT TRUNCATED AT 250 WORDS)