Negative syndrome, persistent negative symptoms and deficit syndrome and their associations with severity of clinical symptoms and level of functioning in 20-year schizophrenia

Purpose: The study assessed the associations between negative symptoms measured with the BPRS-WR (Brief Psychiatric Rating Scale – Withdrawal, Retardation), persistent negative symptoms (PNS) and deficit syndrome (DS) with severity of symptoms and level of functioning in 20-year schizophrenia. Methods: Fifty patients diagnosed with schizophrenia according to DSM III were examined during their first psychiatric hospital admission and after 1, 3, 7, 12 and 20 years. The group with the BPRS-WR symptoms was selected on the basis of an evaluation conducted one year after discharge from their first hospitalization. The PNS and DS groups were selected following examinations performed at discharge and one year later. The proxy for deficit syndrome (PDS) method was used to assess DS. Results: A greater severity of negative syndrome and PNS was associated with greater severity of positive symptoms and poorer general functioning at subsequent measurement points. No such associations were found for the DS. A higher BPRS-WR score was the most stable predictor and explainer of a greater severity of positive and negative schizophrenia symptoms and deterioration in subjects’ functioning over the 20-year period. This association often weakened as the observation time lengthened. Conclusions: The association of negative symptoms with the severity of the symptoms of schizophrenia and the level of functioning decreased as the criteria eliminating secondary negative symptoms were gradually introduced.