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KMID : 0981420000020010077
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Schizophrenia Clinics
2000 Volume.2 No. 1 p.77 ~ p.98
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Deficit Syndrome vs Nondeficit Syndrome of Schizophrenia
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Ahn Yong-Min
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Abstract
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It is generally accepted that schizophrenia is a heterogeneous clinical syndrome. A number of current investigators are using negative symptoms in an attempt to define schizophrenia as a putative disease entity. However, this effort is confounded and potentially undermined by failure to distinguish negative symptoms clearly. The deficit symptoms are proposed by Carpenter et al. to distinguish the primary, enduring negative symptoms from the more transient negative symptoms secondary to other factors. The deficit syndrome is defined as the schizophrenia with the deficit symptoms that are enduring over time independently of the presence or absence of positive symptoms. The deficit syndrome is associated with many clinical characteristics such as poorer pre-morbid and late-life social adjustment, greater social and physical anhedonia, more impaired insight, specific neurological and neuropsychological impairments, and unique pattern of structural and functional brain abnormalities. The deficit syndrome construct offers several advantages over other negative symptom approaches. First, the deficit syndrome is more likely to provide a basis for meaningful subtyping of the schizophrenic syndrome. The deficit syndrome can be made reliably, is stable over time, and is more stable than other negative symptom constructs. Second, the comparison of schizophrenic patients with deficit symptoms and those patients without deficit symptoms enhances the ability to control demographic and clinical variables that could potentially, confound the interpretation of the results. Third, this construct provided the treatment guidelines for the negative symptoms of schizophrenia. In contrast to the deficit symptom, secondary negative symptoms are treatable if the underlying causes are treated correctly. The concept, diagnostic criteria and clinical characteristics of the deficit syndrome are described in this review. It is addressed that there are some problems and limitations for applying the deficit- nondeficit construct to the clinical situation. The issues about the treatment for negative symptoms of schizophrenia(e.g. early detection and earh treatment for preventing the shift from the nondeficit to the deficit syndrome) arc also mentioned.
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KEYWORD
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Schizophrenia, Deficit symptom, Negative symptom, Deficit syndrome
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