title: Individual negative symptoms and domains - Relevance for assessment, pathomechanisms and treatment.
abstract: The negative symptoms of schizophrenia can be divided into two domains. Avolition/apathy includes the individual symptoms of avolition, asociality and anhedonia. Diminished expression includes blunted affect and alogia. Until now, causes and treatment of negative symptoms have remained a major challenge, which is partially related to the focus on negative symptoms as a broad entity. Here, we propose that negative symptoms may become more tractable when the different domains and individual symptoms are taken into account. There is now increasing evidence that the relationship with clinical variables - in particular outcome - differs between the domains of avolition/apathy and diminished expression. Regarding models of negative symptom formation, those relevant to avolition/apathy are now converging on processes underlying goal-directed behavior and dysfunctions of the reward system. In contrast, models of the diminished expression domains are only beginning to emerge. The aim of this article is to review the specific clinical, behavioral and neural correlates of individual symptoms and domains as a better understanding of these areas may facilitate specific treatment approaches.
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland. Electronic address: stefan.kaiser@puk.zh.ch.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kaiser
authors.affiliation: Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland; North Dublin Mental Health Services, Ashlin Centre, Beaumont Road, Dublin 9, Ireland; Dublin and East Treatment and Early Care Team (DETECT) Services, Dublin, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: Lyne
authors.affiliation: Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Agartz
authors.affiliation: Dublin and East Treatment and Early Care Team (DETECT) Services, Dublin, Ireland; College of Life Sciences, University College Dublin, Dublin, Ireland.
authors.forename: Mary
authors.initials: M
authors.lastname: Clarke
authors.affiliation: Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway.
authors.forename: Lynn
authors.initials: L
authors.lastname: Mørch-Johnsen
authors.affiliation: NORMENT and K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, 0424 Oslo, Norway; Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
authors.forename: Ann
authors.initials: A
authors.lastname: Faerden
mesh_terms: D059445:Anhedonia; D057565:Apathy; D003863:Depression / Q000209:etiology*; D006801:Humans; D019964:Mood Disorders / Q000209:etiology*; D011594:Psychometrics; D012559:Schizophrenia / Q000150:complications / Q000628:therapy; D012565:Schizophrenic Psychology
keywords: Amotivation; Apathy; Avolition; Blunted affect; Diminished expression; Negative symptoms