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The authors provide a rationale for distinguishing the primary, enduring negative symptoms of schizophrenia (termed "deficit symptoms") from the more transient negative symptoms secondary to other factors. They argue that the former are more likely to provide a basis for meaningful subtyping of the schizophrenic syndrome, while the latter are more likely to(More)
The significance of neurological signs in schizophrenia is poorly understood. In part, this may reflect the marked variability in the methods of ascertainment in previous studies. The Neurological Evaluation Scale (NES) is designed to standardize the assessment of neurological impairment in schizophrenia. The battery consists of 26 items. Data on the(More)
There is growing interest in deficit symptoms in studies of the course and treatment response of schizophrenia. However, existing clinical assessment instruments focus primarily on productive symptoms. The authors describe the Quality of Life Scale (QLS), a 21-item scale based on a semistructured interview designed to assess deficit symptoms and thereby(More)
The authors review studies of abnormal signs on clinical neurological examination of schizophrenic patients. In spite of a number of methodologic limitations, the cumulative evidence strongly argues that there are more neurological signs in schizophrenic patients than in nonpsychiatric control subjects. Although less consistent, there is considerable(More)
The authors propose using primary and enduring negative or deficit symptoms for dichotomizing schizophrenic patients into two groups, deficit and nondeficit. The validity of this approach was examined by comparing 17 deficit and 17 nondeficit patients for differences in premorbid adjustment and degree of neurological impairment. Deficit patients were(More)
An open comparative trial was conducted involving 42 schizophrenic outpatients randomly assigned to one of two methods of drug administration: continuous medication (N = 21) and targeted medication plus psychosocial intervention (N = 21). The results, which suggest an extensive similarity with respect to outcome for the two treatments over a 2-year period,(More)
The authors report on the outcome of treatment of 116 outpatients with chronic schizophrenia who were assigned to a 2-year, single-blind course of treatment with either targeted or continuous medication. These patients were not restricted to those who were good candidates for a medication reduction strategy. Continuous medication was superior to targeted(More)
The neuropsychological function of 15 deficit and 15 matched nondeficit syndrome schizophrenics was compared to that of 15 age- and sex-matched normal subjects. Both schizophrenic groups performed poorly on the Psychomotor factor compared to the normals. Only the deficit group performed more poorly on the General Performance factor. The results were not(More)
The rational treatment of the negative symptoms of schizophrenia requires a careful differentiation of those secondary to a range of other factors and those that constitute enduring primary or deficit symptoms. Secondary negative symptoms are usually responsive to treatment of the underlying cause. In contrast, there is no intervention currently available(More)
A growing appreciation of the risks of long-term, continuous neuroleptic use in the aftercare of schizophrenic patients has led to a search for alternative strategies. The authors report their experiences with the clinical strategy of "targeted" medication, in which patients are followed drug free until prodromal signs of impending relapse appear.(More)