The deficit syndrome in schizophrenia: psychoanalytic and neurobiological perspectives

The author summarizes recent advances in neurobiological research which appear to offer compelling evidence that the most pathognomonic feature of schizophrenia, the deficit or negative syndrome, is associated with functional abnormalities in the frontal lobe of the brain. These brain abnormalities are correlated with those conceptualized by psychoanalytic theories of withdrawal of libido and loss of mental representation. In the light of this data, the author expresses serious reservations about three psychoanalytic formulations concerning the causes of the deficit syndrome: (1) the syndrome represents, in a primary rather than a secondary way, a psychological defense; (2) it is caused by severe conflicts or neglect during early childhood which lead to impairments in the building up of psychic structure and mental representation; (3) difficulties with the aggressive drive play a primary etiological role.