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Negative v positive schizophrenia. Definition and validation

N C Andreasen, S Olsen

    Archives of General Psychiatry
    |July 1, 1982
    PubMed
    Summary
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    Researchers defined criteria for three subtypes of schizophrenia: positive, negative, and mixed. These subtypes showed significant differences in cognitive dysfunction, brain structure, and illness course, validating the new classification for schizophrenia research.

    Area of Science:

    • Psychiatry
    • Clinical Psychology
    • Neuroscience

    Background:

    • Schizophrenia is a complex psychiatric disorder with varied symptom presentations.
    • Existing diagnostic criteria may not fully capture the heterogeneity of schizophrenia.
    • Subtyping schizophrenia could improve understanding and treatment.

    Purpose of the Study:

    • To develop and validate criteria for classifying schizophrenia into positive, negative, and mixed subtypes.
    • To explore the clinical and biological correlates of these proposed subtypes.

    Main Methods:

    • Defined criteria for positive schizophrenia (delusions, hallucinations, thought disorder, bizarre behavior).
    • Defined criteria for negative schizophrenia (affective flattening, alogia, avolition, anhedonia, attentional impairment).

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  • Defined criteria for mixed schizophrenia (prominent positive and negative symptoms, or neither).
  • Assessed validity using external measures: premorbid adjustment, cognitive dysfunction, ventricular brain ratio, and hospital course.

    • Main Results:

    • Significant differences were observed between the three subtypes across external validators.
    • Positive schizophrenia subtypes exhibited distinct symptom profiles.
    • Negative schizophrenia subtypes showed specific patterns of cognitive and biological markers.
    • Mixed schizophrenia subtypes presented unique clinical characteristics.

    Conclusions:

    • The proposed criteria provide a valid method for subtyping schizophrenia.
    • These subtypes demonstrate distinct patterns in cognitive function, brain structure, and clinical course.
    • This subtyping approach may enhance research and clinical practice in schizophrenia.