61 Primary Negative Symptoms: Appraisal of a Misty Outlook Saeed Shoja Shafti* Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Iran *Corresponding author: Saeed Shoja Shafti, Professor of Psychiatry, University of Social Welfare and Rehabilitation Sciences (USWR), Razi Psychiatric Hospital, Tehran, Iran. To Cite This Article: Saeed Shoja Shafti. Primary Negative Symptoms: Appraisal of a Misty Outlook. Am J Biomed Sci & Res. 2019 - 2(2). AJBSR. MS.ID.000573. DOI: 10.34297/AJBSR.2019.02.000573 Received: February 06, 2019 | Published: March 28, 2019 Copy Right@ Saeed Shoja Shafti Review Article American Journal of Biomedical Science & Research www.biomedgrid.com --------------------------------------------------------------------------------------------------------------------------------- This work is licensed under Creative Commons Attribution 4.0 License AJBSR.MS.ID.000573. Introduction According to DSM-5 and for diagnosis of schizophrenia:” …. At least two Criterion A symptoms must be present for a significant portion of time during a 1-month period or longer. At least one of these symptoms must be the clear presence of delusions (Criterion Al), hallucinations (Criterion A2), or disorganized speech (Criterion A3). Grossly disorganized or catatonic behavior (Criterion A4) and negative symptoms (Criterion A5) may also be present. Schizophrenia involves impairment in one or more major areas of functioning (Criterion B). Avolition (i.e., reduced drive to pursue goal-directed behavior; Criterion A5) is linked to the social dysfunction described under Criterion B. There is also strong evidence for a relationship between cognitive impairment and functional impairment in individuals with schizophrenia. Some signs of the disturbance must persist for a continuous period of at least 6 months (Criterion C). Prodromal symptoms often precede the active phase, and residual symptoms may follow it, characterized by mild or sub-threshold forms of hallucinations or delusions. Negative symptoms are common in the prodromal and residual phases and can be severe. Individuals who had been socially active may become withdrawn from previous routines. Such behaviors are often the first sign of a disorder….” “…. Negative symptoms account for a substantial portion of the morbidity associated with schizophrenia but are less prominent in other psychotic disorders. Two negative symptoms are particularly prominent in schizophrenia: diminished emotional expression and avolition. Diminished emotional expression includes reductions in the expression of emotions in the face, eye contact, intonation of speech (prosody), and movements of the hand, head, and face that normally give an emotional emphasis to speech. Avolition is a decrease in motivated self-initiated purposeful activities. The individual may sit for long periods of time and show little interest in participating in work or social activities. Other negative symptoms include alogia, anhedonia, and asociality. Alogia is manifested by diminished speech output. Anhedonia is the decreased ability to experience pleasure from positive stimuli or degradation in the recollection of pleasure previously experienced. Asociality refers to the apparent lack of interest in social interactions and may be associated with avolition, but it can also be a manifestation of limited opportunities for social interactions……” [1]. So again, negative symptoms in schizophrenia, as one of the main criteria in DSM-5, include: a. Restricted up to flat affect, b. Apathy, c. Alogia, Summary Negative symptoms, which are among the main criteria in DSM-5 for diagnosis of schizophrenia, are categorized by some of the researchers into ‘primary vs. secondary‘, ‘enduring vs. transitory‘ and ‘treatment-resistant vs. treatment-responsive’ groups. Besides, adjunctive strategies are desperately acknowledged as the necessary complementary inventions in this regard. But according to a quantity of data, such invented classification into above-mentioned clusters, may not be verified reasonably. In addition, unconditional pessimistic standpoint regarding inflexibility of ‘primary negative symptoms’, against therapeutic approaches, does not seem to be tenable and thus needs to be revised. So, the time has arrived for a critical review about such a conjectural dichotomy, which is seeking diligently cure for no authentic theme. ISSN: 2642-1747