Drug and Subject Influences on Measures of Depression and Negative Symptoms in Schizophrenic Patients
Kraepelin (1) and Bleuler (2) in their seminal writings pointed out that “genuine depression” frequently occurred in schizophrenic patients and suggested that dysphoric mood arose due to awareness of the disorder and its limiting influence on their life. In the formal development of mental disorder taxonomies a preference was expressed for orthogonal dimensions which implied that pure schizophrenia excluded depression. The sheer weight of clinical observations that depressive features occurred in schizophrenic patients was tentatively acknowledged in the designation of “Schizoaffective Disorder” and DSM-III-R (3) (p. 208) notes that this “represents one of the most confusing and controversial concepts in psychiatric nosology”. Some investigators interpreted “depression-like” symptoms to be manifestations of Bleuler’s symptoms, now rediscovered and referred to as “negative symptoms”. These include affective flattening and alogia. Still others have suggested that depressed states are pharmacogenically induced (4–6). This latter idea has not received support in more recent and properly controlled investigations (7, 8).
KeywordsBeck Depression Inventory Negative Symptom Schizophrenic Patient Schizoaffective Disorder Dysphoric Mood
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