What is the concept of negative symptoms in schizophrenia?

Negative symptoms in schizophrenia refer to the absence or reduction of normal behaviours and experiences.

Negative symptoms are a core feature of schizophrenia and can be divided into two categories: primary and secondary. Primary negative symptoms are those that are inherent to the disorder and include affective flattening, alogia, and avolition. Affective flattening refers to a reduction in the display of emotions, while alogia is a decrease in the amount or content of speech. Avolition refers to a lack of motivation and goal-directed behaviour.

Secondary negative symptoms are those that are a result of other factors, such as medication or depression. These can include apathy, anhedonia, and social withdrawal.

Negative symptoms can have a significant impact on a person's ability to function in daily life and are often associated with poorer outcomes in terms of social and occupational functioning. They are also often resistant to treatment with antipsychotic medication, which primarily targets positive symptoms such as hallucinations and delusions.

Research into the underlying mechanisms of negative symptoms is ongoing, with current theories focusing on abnormalities in brain regions involved in reward processing and motivation. Treatment approaches that target these mechanisms, such as cognitive remediation and social skills training, have shown promise in improving negative symptoms in schizophrenia.