Negative v positive schizophrenia. Definition and validation

Abstract

We developed criteria for dividing the schizophrenic syndrome into three subtypes: positive, negative, and mixed schizophrenia. Positive schizophrenia is characterized by prominent delusions, hallucinations, positive formal thought disorder, and persistently bizarre behavior; negative schizophrenia, by affective flattening, alogia, avolition, anhedonia, and attentional impairment. In mixed schizophrenia either both negative and positive symptoms are prominent, or neither is prominent. We explored the validity of these criteria in a variety of ways. Significant differences between the three types were noted using external validators such as premorbid adjustment, indices of cognitive dysfunction, ventricular brain ratio, and course in hospital. The correlational structure of the symptom complexes also provided further support for our approach to subtyping.