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Schizophrenia: Recognition and Treatment of Negative Symptoms in Schizophrenia

Written by
Dr. Alok Vinod Kulkarni
and medically reviewed by iCliniq medical review team.

Published on Feb 15, 2015 and last reviewed on Sep 07, 2018   -  5 min read



Negative symptoms have time and again proven to be the most difficult aspects in the treatment of schizophrenia. This article focuses on a brief description of the types of negative symptoms, their progress over the course of the illness, and newer emerging molecular targets for their treatment.

Schizophrenia: Recognition and Treatment of Negative Symptoms in Schizophrenia

What is Schizophrenia?

Schizophrenia is a complex brain disorder, which has its pathogenesis in neurodevelopmental anomalies. The 5 domains of schizophrenia include:

Negative Symptoms

Negative symptoms include blunted affect, alogia, avolition, asociality, amotivation, anhedonia, ideational constriction, apathy or inertia, and abulia.

However, negative symptoms are not unique to schizophrenia alone.

Classification of Negative Symptoms

Negative symptoms are attributed to deficits in the brain circuitry concerning reward (nucleus accumbens), motivation and pleasure. Negative symptoms may be further classified into:

What Causes Secondary Negative Symptoms?

Deficit Syndrome

Degree of Future Negative Symptoms


Factoring in all these points, it becomes imperative to seek comprehensive professional psychiatric help early in the course of the illness. The prodromal phase of schizophrenia presents with memory disturbances, vague anxiety and depressive symptoms, progressive social withdrawal, before the positive symptoms set in. This prodrome can last as long as 5 years before the onset of core psychotic symptoms, like delusions and hallucinations.

Management of Negative Symptoms

Non-pharmacological Management:

(a) Psychosocial interventions: These are as important as psychopharmacological interventions, if not more. Forming support groups, and meeting at regular intervals of these groups is important. During these group meetings, individual experiences and problems are voiced, client participation is encouraged, the progress made so far is assessed, and future goals are ascertained.

(b) Cognitive Behavioral Therapy (CBT): Therapists aid the clients in unlearning older maladaptive behaviors, and focusing on learning newer adaptive ones. Therapy is always individualized as there is no one-size-fits-all treatment. Studies have consistently shown that individual therapy is better than group therapy in the treatment of negative symptoms.

(c) Cognitive remediation therapy for cognitive deficits: This includes pencil-paper tasks, sudoku, crossword, computer exercises. These exercises need to be tailored to focus on deficits in individual domains like attention, speed of thought processing, verbal working memory, reasoning, and social cognition.

(d) Aerobic exercises help in neurogenesis, synaptogenesis, and modulate neuroplasticity.

Pharmacological Management:

Brain Stimulation Techniques:

Novel Treatment Approaches:

There is definitely hope for those afflicted with the deficit syndrome, what with researchers identifying a plethora of molecular targets. Consult a psychiatrist online for management of schizophrenia -->


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Last reviewed at:
07 Sep 2018  -  5 min read


Dr. Alok Vinod Kulkarni

Dr. Alok Vinod Kulkarni

MBBS, DPM (NIMHANS), (MD) Psychiatry

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