This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (120)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Schizophrenia  • Diagnosis  • Alert me on articles by topic

Brian Kirkpatrick, MD; Robert W. Buchanan, MD; David E. Ross, MD; William T. Carpenter, Jr, MD

Arch Gen Psychiatry. 2001;58:165-171.

ABSTRACT
If schizophrenia is a clinical syndrome rather than a single disease, the identification of specific diseases within the syndrome would facilitate the advance of knowledge and the development of more specific treatments. We propose that deficit psychopathology (ie, enduring, idiopathic negative symptoms) defines a group of patients with a disease different from schizophrenia without deficit features, as the deficit and nondeficit groups differ in their signs and symptoms, course, biological correlates, treatment response, and etiologic factors. These differences cannot be attributed to more severe positive psychotic symptoms or a greater duration of illness in the deficit group. The alternative interpretation that patients with deficit schizophrenia are at the severe end of a single disease continuum is not supported by risk factor and biological features data, but there is a need for independent replication of these findings. We suggest a series of studies designed to falsify one of these hypotheses, ie, multiple diseases vs a single disease.

From the Maryland Psychiatric Research Center, Baltimore (Drs Kirkpatrick, Buchanan, and Carpenter), and the Departments of Psychiatry, University of Maryland, Baltimore (Drs Kirkpatrick, Buchanan, and Carpenter), and Medical College of Virginia, Richmond (Dr Ross). The work of Drs Kirkpatrick, Buchanan, and Carpenter is supported in part by Novartis.

Corresponding author and reprints: Brian Kirkpatrick, MD, Maryland Psychiatric Research Center, PO Box 21247, Baltimore, MD 21228 (e-mail: bkirkpatr{at}aol.com).

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Periods of Recovery in Deficit Syndrome Schizophrenia: A 20-Year Multi-follow-up Longitudinal Study
Strauss et al.
Schizophr Bull 2008;0:sbn167v1-sbn167.
ABSTRACT | FULL TEXT  

Psychiatric Comorbidities and Schizophrenia
Buckley et al.
Schizophr Bull 2008;0:sbn135v1-sbn135.
ABSTRACT | FULL TEXT  

Destigmatising schizophrenia: does changing terminology reduce negative attitudes?
Kingdon et al.
Psychiatr. Bull. 2008;32:419-422.
ABSTRACT | FULL TEXT  

Negative Symptoms in Schizophrenia: Avolition and Occam's Razor
Foussias and Remington
Schizophr Bull 2008;0:sbn094v1-sbn094.
ABSTRACT | FULL TEXT  

Emotional Experience in Patients With Schizophrenia Revisited: Meta-analysis of Laboratory Studies
Cohen and Minor
Schizophr Bull 2008;0:sbn061v1-sbn061.
ABSTRACT | FULL TEXT  

Prevention of Negative Symptom Psychopathologies in First-Episode Schizophrenia: Two-Year Effects of Reducing the Duration of Untreated Psychosis
Melle et al.
Arch Gen Psychiatry 2008;65:634-640.
ABSTRACT | FULL TEXT  

Patterns of Structural MRI Abnormalities in Deficit and Nondeficit Schizophrenia
Galderisi et al.
Schizophr Bull 2008;34:393-401.
ABSTRACT | FULL TEXT  

Neuropsychology of the Deficit Syndrome: New Data and Meta-analysis of Findings To Date
Cohen et al.
Schizophr Bull 2007;33:1201-1212.
ABSTRACT | FULL TEXT  

Persistent Negative Symptoms in Schizophrenia: An Overview
Buchanan
Schizophr Bull 2007;33:1013-1022.
ABSTRACT | FULL TEXT  

Cognitive Functioning in the Schizophrenia Prodrome
Simon et al.
Schizophr Bull 2007;33:761-771.
ABSTRACT | FULL TEXT  

Genetic Heterogeneity, Modifier Genes, and Quantitative Phenotypes in Psychiatric Illness: Searching for a Framework
Fanous and Kendler
Focus 2006;4:423.
ABSTRACT | FULL TEXT  

Deficit Schizophrenia: Association With Serum Antibodies to Cytomegalovirus
Dickerson et al.
Schizophr Bull 2006;32:396-400.
ABSTRACT | FULL TEXT  

The Factorial Structure of the Schedule for the Deficit Syndrome in Schizophrenia
Kimhy et al.
Schizophr Bull 2006;32:274-278.
ABSTRACT | FULL TEXT  

The Structure of Negative Symptoms Within Schizophrenia: Implications for Assessment
Blanchard and Cohen
Schizophr Bull 2006;32:238-245.
ABSTRACT | FULL TEXT  

The NIMH-MATRICS Consensus Statement on Negative Symptoms
Kirkpatrick et al.
Schizophr Bull 2006;32:214-219.
FULL TEXT  

Negative Signs and Symptoms Secondary to Antipsychotics: A Double-Blind, Randomized Trial of a Single Dose of Placebo, Haloperidol, and Risperidone in Healthy Volunteers
Artaloytia et al.
Am. J. Psychiatry 2006;163:488-493.
ABSTRACT | FULL TEXT  

Neurobiology of early psychosis
KESHAVAN et al.
Br. J. Psychiatry 2005;187:s8-s18.
ABSTRACT | FULL TEXT  

First-Episode Psychosis: Psychopathology, Quality of Life, and Functional Outcome
Malla and Payne
Schizophr Bull 2005;31:650-671.
ABSTRACT | FULL TEXT  

Structural Brain Imaging Evidence for Multiple Pathological Processes at Different Stages of Brain Development in Schizophrenia
Pantelis et al.
Schizophr Bull 2005;31:672-696.
ABSTRACT | FULL TEXT  

Do Patients with Schizophrenia Ever Show Periods of Recovery? A 15-Year Multi-Follow-up Study
Harrow et al.
Schizophr Bull 2005;31:723-734.
ABSTRACT | FULL TEXT  

Association Between the Neuregulin 1 Gene and Schizophrenia: A Systematic Review
Tosato et al.
Schizophr Bull 2005;31:613-617.
ABSTRACT | FULL TEXT  

A Summary of the FDA-NIMH-MATRICS Workshop on Clinical Trial Design for Neurocognitive Drugs for Schizophrenia
Buchanan et al.
Schizophr Bull 2005;31:5-19.
ABSTRACT | FULL TEXT  

Summer Birth and Deficit Schizophrenia: A Pooled Analysis From 6 Countries
Messias et al.
Arch Gen Psychiatry 2004;61:985-989.
ABSTRACT | FULL TEXT  

Dr. Kirkpatrick and Colleagues Reply
KIRKPATRICK et al.
Am. J. Psychiatry 2003;160:595-596.
FULL TEXT  

Psychosis as a State of Aberrant Salience: A Framework Linking Biology, Phenomenology, and Pharmacology in Schizophrenia
Kapur
Am. J. Psychiatry 2003;160:13-23.
ABSTRACT | FULL TEXT  

Summer Birth and Deficit Schizophrenia in Dumfries and Galloway, Southwestern Scotland
Kirkpatrick et al.
Am. J. Psychiatry 2002;159:1382-1387.
ABSTRACT | FULL TEXT  

A 23-Year-Old Man With Schizophrenia
Goff
JAMA 2002;287:3249-3257.
FULL TEXT  

Historical, Psychopathological, Neurological, and Neuropsychological Aspects of Deficit Schizophrenia: A Multicenter Study
Galderisi et al.
Am. J. Psychiatry 2002;159:983-990.
ABSTRACT | FULL TEXT