1. Explain the difference between positive and negative symptoms. How do these symptoms affect the functional outcomes and quality of life for individuals with schizophrenia? A dichotomous model of diagnosis is used in classifying the symptoms most commonly found in schizophrenia, in positive and negative symptoms (Boyle, 2002; American Psychiatric Association, 2013; Comer, 2013).
The difference between positive and negative symptoms consists in the positive symptoms bringing changes, ‘pathological excesses’ or bizarre additions to the sufferer’s thinking (such as hallucinations or delusions), while negative symptoms represent withdrawals or ‘pathological deficits’ (such as diminished emotional expression or avolition) (American Psychiatric Association, 2013; Kring et al., 2013).
Patients with schizophrenia normally experience a combination of both positive and negative symptoms in different degrees of preponderance however, negative symptoms tend to gradually develop during the prodromal period, while positive symptoms tend to occur predominantly during acute, active phases of the malady (Comer, 2013).
The neurobiology of schizophrenia is not yet well understood however, neuroimaging studies suggest that negative symptoms are associated primarily with frontal lobe malfunction, which affect executive functions, although other regions of the brain are also affected, such as the temporal lobes and the limbic system (Liddle, 2002). Positive symptoms are believed to occur as a byproduct of dopamine activity (‘The negative symptoms of schizophrenia’, 2006).
The prevalence of positive and negative symptoms was found to be correlated with the outcomes and prognosis for recovery. Studies suggest that patients with less negative and more positive symptoms appear to have better outcomes for recovery than those with more negative symptoms. This is thought to be due to the fact that negative symptoms seem to be more debilitating and to affect patient’s life to a greater degree than the positive symptoms, which are more successfully treated with antipsychotic medication (‘The negative symptoms of schizophrenia, 2006).
Studies indicate that positive symptoms tend to be more severe in patients with late onset than in patients with early onsets (Pearman & Batra, 2012). However patients generally report positive symptoms as most frightening and stressful and the presence of positive symptoms seems to make treatment needed urgently (Flanagal et al., 2012).
Negative symptoms conversely, are more pervasive and persistent and have a much greater impact on a patient’s quality of life, being at the same time especially difficult to treat. Antipsychotic medication used in treating schizophrenia patients appear to have low efficacy in treating negative symptoms. Some studies indicate that the side effects of antipsychotic medication could actually aggravate patients’ negative symptoms by further reducing the frontal lobe activity and as a result of their sedative effect (The negative symptoms of schizophrenia, 2006).
Researches available seem contradictory and it is not yet clear whether the predominance of positive or the negative symptoms can lead to depression (75% of schizophrenia patients have at least one major depression episode during their life) and suicide risk increase (which is 5% higher in schizophrenia patients) (Bagarić, Brečić, Ostojić, Jukić, & Goleš, 2013).
Symptoms of schizophrenia invade every aspect of the sufferers’ life as the disorder usually affects the patients’ cognition, behavior and emotions. Schizophrenia was described as one of the leading causes of disability and as a life shortening illness, associated