Negative symptoms at discharge and outcome in schizophrenia.

Background: The clinical significance in schizophrenia of positive and negative symptoms at discharge was assessed.

Methods: Of schizophrenic patients fulfilling DSM-III criteria, 113 were recruited for this study. Personal, social and psychopathological data were collected and all cases were followed up at one and two years after discharge.

Results: The presence of positive symptoms (64 cases), without concomitant negative symptoms, did not predict the follow-up social function and positive symptom score. Conversely, the presence of negative symptoms (31 cases) predicted worse social functioning (P < 0.05 to P < 0.005) and higher positive symptom scores (P < 0.01) at follow-up using MANOVA: Eighteen cases (15.9%) had neither positive nor negative symptoms and had the best clinical outcome.

Conclusions: Negative, but not positive, symptoms assessed at discharge are an important predictor of poor outcome. In addition, negative symptoms may themselves expose a biological vulnerability to the presence of positive symptoms.