Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-05T09:26:51.704Z Has data issue: false hasContentIssue false

Deficit schizophrenia: An overview of clinical, biological and treatment aspects

Published online by Cambridge University Press:  16 April 2020

S. Galderisi*
Affiliation:
Department of Psychiatry, Medical School, University of Naples SUN, Largo Madonna delle Grazie, 80134Naples, Italy
M. Maj
Affiliation:
Department of Psychiatry, Medical School, University of Naples SUN, Largo Madonna delle Grazie, 80134Naples, Italy
*
*Corresponding author. Tel.: +39 0815 666 504; fax +39 0815 666 523. E-mail address:[email protected] (M. Bernardo).
Get access

Abstract

The concept of deficit schizophrenia is regarded as one of the most promising attempts to reduce heterogeneity within schizophrenia. This paper summarizes the clinical, neurocognitive, brain imaging and electrophysiological correlates of this subtype of schizophrenia. Attempts to identify genetic and non-genetic risk factors are reviewed. Methodological limitations of studies supporting the efficacy of atypical antipsychotics in the treatment of the syndrome are highlighted. Two decades of research on deficit schizophrenia have failed to prove that it represents the extreme end of a severity continuum in schizophrenia, while some findings support the claim that it may be a separate disease entity.

Type
Review
Copyright
Copyright © Elsevier Masson SAS 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Amador, XFKirkpatrick, BBuchanan, RWCarpenter, WTMarcinko, LYale, SAStability of the diagnosis of deficit syndrome in schizophrenia. Am J Psychiatry 1999;156:637639Google Scholar
Andreasen, NCOlsen, SNegative versus positive schizophrenia. Arch Gen Psychiatry 1982;39:789794CrossRefGoogle Scholar
Arango, CKirkpatrick, BBuchanan, RWNeurological signs and the heterogeneity of schizophrenia. Am J Psychiatry 2000;157:560565CrossRefGoogle ScholarPubMed
Arndt, SAndreasen, NCFlaum, MMiller, DNopoulos, PA longitudinal study of symptoms dimensions in schizophrenia: prediction and patterns of changes. Arch Gen Psychiatry 1995;52:352360CrossRefGoogle Scholar
Bakker, SCHoogendoorn, MLHendriks, JVerzijlbergen, KCaron, SVerduijn, Wet al.The PIP5K2A and RGS4 genes are differentially associated with deficit and non-deficit schizophrenia. Genes Brain Behav 2007;6:113119CrossRefGoogle ScholarPubMed
Boyer, PLecrubier, YPuech, AJDewailly, JAubin, FTreatment of negative symptoms in schizophrenia with amisulpride. Br J Psychiatry 1995;166:6872CrossRefGoogle ScholarPubMed
Breier, ABuchanan, RWKirkpatrick, BDavis, ORIrish, DSummerfelt, Aet al.Effects of clozapine on positive and negative symptoms in outpatients with schizophrenia. Am J Psychiatry 1994;151:2026Google ScholarPubMed
Bryson, GWhelahan, HABell, MMemory and executive function impairments in deficit syndrome schizophrenia. Psychiatry Res 2001;102:2937CrossRefGoogle ScholarPubMed
Bucci, PMucci, AMerlotti, EVolpe, UGalderisi, SInduced gamma activity and event-related coherence in schizophrenia. Clin EEG Neurosci 2007;38:97104CrossRefGoogle Scholar
Buchanan, RWBreier, AKirkpatrick, BBall, PCarpenter, WT Jr.Positive and negative symptom response to clozapine in schizophrenic patients with and without the deficit syndrome. Am J Psychiatry 1998;155:751760Google ScholarPubMed
Buchanan, RWBreier, AKirkpatrick, BElkashef, AMunson, RCGellad, Fet al.Structural abnormalities in deficit vs non-deficit schizophrenia. Am J Psychiatry 1993;150:5965Google Scholar
Buchanan, RWHeinrichs, DWThe Neurological Evaluation Scale (NES): a structured instrument for the assessment of neurological signs in schizophrenia. Psychiatry Res 1988;27:335350CrossRefGoogle Scholar
Buchanan, RWKirkpatrick, BHeinrichs, DWCarpenter, WT Jr.Clinical correlates of the deficit syndrome of schizophrenia. Am J Psychiatry 1990;147:290294Google ScholarPubMed
Buchanan, RWStrauss, MEKirkpatrick, BHolstein, CBreier, ACarpenter, WT Jr.Neuropsychological impairments in deficit vs nondeficit forms of schizophrenia. Arch Gen Psychiatry 1994;51:804811CrossRefGoogle ScholarPubMed
Cannon-Spoor, HEPotkin, SGWyatt, RJMeasurement of premorbid adjustment in schizophrenia. Schizophr Bull 1982;8:470484CrossRefGoogle Scholar
Carpenter, WT Jr.Heinrichs, DWWagman, AMIDeficit and non-deficit forms of schizophrenia: the concept. Am J Psychiatry 1988;145:578583Google Scholar
Cohen, ASSaperstein, AMGold, JMKirkpatrick, BCarpenter, WT Jr.Buchanan, RWNeuropsychology of the deficit syndrome: new data and meta-analysis of findings to date. Schizophr Bull 2007;33:12011212CrossRefGoogle ScholarPubMed
Crow, TJThe two-syndrome concept: origins and current status. Schizophr Bull 1985;11:471486CrossRefGoogle ScholarPubMed
Danion, JMRein, WFleurot, OAmisulpride Study Group Improvement of schizophrenic patients with primary negative symptoms treated with amisulpride. Am J Psychiatry 1999;156:610616Google ScholarPubMed
Davies, GWJChant, DTorrey, EFMcGrath, JA systematic review and meta-analysis of Northern Hemisphere season of birth studies in schizophrenia. Schizophr Bull 2003;29:587593CrossRefGoogle Scholar
Delamillieure, PFernandez, JConstans, JMBrazo, PBenali, KAbadie, Pet al.Proton magnetic resonance spectroscopy of the medial prefrontal cortex in patients with deficit schizophrenia: preliminary report. Am J Psychiatry 2000;157:641643CrossRefGoogle ScholarPubMed
Dickerson, FKirkpatrick, BBoronow, JStallings, COrigoni, AYolken, RDeficit schizophrenia: association with serum antibodies to cytomegalovirus. Schizophr Bull 2006;32:396400CrossRefGoogle ScholarPubMed
Dollfus, SBrazo, PLanglois, SGourevitch, RDassa, DBesse, Fet al.Month of birth in deficit and non-deficit schizophrenic patients. Eur Psychiatry 1999;14:349351CrossRefGoogle ScholarPubMed
Dollfus, SGermain-Robin, SChabot, BBrazo, PDelamillieure, PLanglois, Set al.Family history and obstetric complications in deficit and non-deficit schizophrenia: preliminary results. Eur Psychiatry 1998;13:270272CrossRefGoogle ScholarPubMed
Fenton, WSMcGlashan, THVictor, BJBlyler, CRSymptoms, subtype, and suicidality in patients with schizophrenia spectrum disorders. Am J Psychiatry 1997;154:199204Google ScholarPubMed
Fenton, WSMcGlashan, THAntecedents, symptom progression, and long-term outcome of the deficit syndrome in schizophrenia. Am J Psychiatry 1994;151:351356Google Scholar
Galderisi, SMaj, MKirkpatrick, BPiccardi, PMucci, AInvernizzi, Get al.Catechol-O-methyltransferase Val 158 Met polymorphism in schizophrenia: associations with cognitive and motor impairment. Neuropsychobiology 2005;52:8389CrossRefGoogle ScholarPubMed
Galderisi, SMaj, MKirkpatrick, BPiccardi, PMucci, AInvernizzi, Get al.COMT Val (158) Met and BDNF C (270) T polymorphisms in schizophrenia: a case-control study. Schizophr Res 2005;73:2730CrossRefGoogle Scholar
Galderisi, SMaj, MMucci, ACassano, GBInvernizzi, GRossi, Aet al.Historical, psychopathological, neurological and neuropsychological aspects of deficit schizophrenia: a multicenter study. Am J Psychiatry 2002;159:983990CrossRefGoogle ScholarPubMed
Galderisi, SMucci, AMignone, MLBucci, PMaj, MHemispheric asymmetry and psychopathological dimensions in drug-free patients with schizophrenia. Int J Psychophysiol 1999;34:293301CrossRefGoogle ScholarPubMed
Galderisi, S, Quarantelli, M, Volpe, U, Mucci, A, Cassano, GB, Invernizzi, G, et al.Patterns of structural MRI abnormalities in deficit and non-deficit schizophrenia. Schizophr Bull 2008; 34: 393401.CrossRefGoogle Scholar
Goetz, RRCorcoran, CYale, SStanford, ADKimhy, DAmador, Xet al.Validity of a ‘proxy’ for the deficit syndrome derived from the Positive And Negative Syndrome Scale (PANSS). Schizophr Res 2007;93:169177CrossRefGoogle Scholar
Gonul, ASKula, MEsel, ETutus, ASofuogluc, SA Tc-99m HMPAO SPECT study of regional cerebral blood flow in drug-free schizophrenic patients with deficit and non-deficit syndrome. Psychiatry Res Neuroimaging 2003;123:199205CrossRefGoogle ScholarPubMed
Gur, REMozley, PDShtasel, DLet al.Clinical subtypes of schizophrenia: differences in brain and CSF volume. Am J Psychiatry 1994;151:343350Google ScholarPubMed
Heckers, SGoff, DSchacter, DLSavage, CRFischman, AJAlpert, NMet al.Functional imaging of memory retrieval in deficit vs non-deficit schizophrenia. Arch Gen Psychiatry 1999;56:11171123CrossRefGoogle Scholar
Hong, LEAvila, MTAdami, HElliot, AThaker, GKComponents of the smooth pursuit function in deficit and non-deficit schizophrenia. Schizophr Res 2003;63:3948CrossRefGoogle Scholar
Johnstone, ECOwen, DGFrith, CDCrow, TJThe relative stability of positive and negative features in chronic schizophrenia. Br J Psychiatry 1987;150:6064CrossRefGoogle ScholarPubMed
Kay, SRSingh, MMThe positive-negative distinction in drug-free schizophrenic patients. Stability, response to neuroleptics, and prognostic significance. Arch Gen Psychiatry 1989;46:711718CrossRefGoogle ScholarPubMed
Kimhy, DYale, SGoetz, RRMcFarr, LMMalaspina, DThe factorial structure of the Schedule for the Deficit Syndrome in schizophrenia. Schizophr Bull 2006;32:274278CrossRefGoogle Scholar
Kirkpatrick, BAmador, XAYale, SABustillo, JRBuchanan, RWTohen, MThe deficit syndrome in the DSM-IV Field Trial. Part II. Depressive episodes and persecutory beliefs. Schizophr Res 1996;20:7990CrossRefGoogle ScholarPubMed
Kirkpatrick, BAmador, XSFlaum, MYale, SAGorman, JMCarpenter, WTet al.The deficit syndrome in the DSM-IV Field Trial. I: alcohol and other drug abuse. Schizophr Res 1996;20:6977CrossRefGoogle Scholar
Kirkpatrick, BBuchanan, RWBreier, ACarpenter, WT Jr.Case identification and stability of the deficit syndrome of schizophrenia. Psychiatry Res 1993;47:4756CrossRefGoogle ScholarPubMed
Kirkpatrick, BBuchanan, RWBreier, ACarpenter, WT Jr.Depressive symptoms and the deficit syndrome of schizophrenia. J Nerv Ment Dis 1994;182:452455CrossRefGoogle ScholarPubMed
Kirkpatrick, BBuchanan, RWMcKenney, PDAlphs, LDCarpenter, WT Jr.The schedule for the deficit syndrome: an instrument for research in schizophrenia. Psychiatry Res 1989;30:119124CrossRefGoogle Scholar
Kirkpatrick, BBuchanan, RWRoss, DECarpenter, WT Jr.A separate disease within the syndrome of schizophrenia. Arch Gen Psychiatry 2001;58:165171CrossRefGoogle ScholarPubMed
Kirkpatrick, BBuchanan, RWAnhedonia and the deficit syndrome of schizophrenia. Psychiatry Res 1990;31:2530CrossRefGoogle ScholarPubMed
Kirkpatrick, BCastle, DMurray, RMCarpenter, WTRisk factors for the deficit syndrome of schizophrenia. Schizophr Bull 2000;26:233242CrossRefGoogle ScholarPubMed
Kirkpatrick, BConley, RCKakoyannis, AReep, RLRoberts, RCInterstitial cells of the white matter in the inferior parietal cortex in schizophrenia: an unbiased cell-counting study. Synapse 1999;34:951023.0.CO;2-I>CrossRefGoogle ScholarPubMed
Kirkpatrick, BFenton, WSCarpenter, WT Jr.Marder, SRThe NIMH-MATRICS consensus statement on negative symptoms. Schizophr Bull 2006;32:214219CrossRefGoogle ScholarPubMed
Kirkpatrick, BHerrera Castanedo, SVazquez-Barquero, JLSummer birth and deficit schizophrenia: Cantabria, Spain. J Nerv Ment Dis 2002;190:526532CrossRefGoogle ScholarPubMed
Kirkpatrick, BKopelowicz, ABuchanan, RWCarpenter, WT Jr.Assessing the efficacy of treatments for the deficit syndrome of schizophrenia. Neuropsychopharmacology 2000;22:303310CrossRefGoogle ScholarPubMed
Kirkpatrick, BMessias, NCConley, RRRoberts, RCInterstitial cells of the white matter in the dorsolateral prefrontal cortex in deficit and non-deficit schizophrenia. J Nerv Ment Dis 2003;191:563567CrossRefGoogle Scholar
Kirkpatrick, BRam, RBromet, EThe deficit syndrome in the Suffolk County Mental Health Project. Schizophr Res 1996;22:119126CrossRefGoogle ScholarPubMed
Kirkpatrick, BRoss, DEWalsh, DKarkowski, LKendler, KSFamily characteristics of deficit and non-deficit schizophrenia in the Roscommon Family Study. Schizophr Res 2000;45:5764CrossRefGoogle Scholar
Kirkpatrick, BTek, CAllardyce, JMorrison, GMcCreadie, RGSummer birth and deficit schizophrenia in Dumfries and Galloway, Southwestern Scotland. Am J Psychiatry 2002;150:13821387CrossRefGoogle Scholar
Kopelowicz, AZarate, RTripodis, KGonzalez, VMintz, JDifferential efficacy of olanzapine for deficit and non-deficit negative symptoms in schizophrenia. Am J Psychiatry 2000;157:987993CrossRefGoogle Scholar
Kraepelin, EPsychiatrie: ein lehrbuch fur studierende und artze 5. AuflageLeipzigA. Abel 1896Google Scholar
Lahti, ACHolcomb, HHMedoff, DRWeiler, MATamminga, CACarpenter, WT Jr.Abnormal patterns of regional cerebral blood flow in schizophrenia with primary negative symptoms during an effortful auditory recognition task. Am J Psychiatry 2001;158:17971808CrossRefGoogle ScholarPubMed
Lecrubier, YQuintin, PBouhassira, MPerrin, ELancrenon, SThe treatment of negative symptoms and deficit states of chronic schizophrenia: olanzapine compared to amisulpride and placebo in a 6-month double-blind controlled clinical trial. Acta Psychiatr Scand 2006;114:319327CrossRefGoogle Scholar
Lee, KHWilliams, LMLoughland, CMDavidson, DJGordon, ESyndromes of schizophrenia and smooth-pursuit eye movement dysfunction. Psychiatry Res 2001;101:1121CrossRefGoogle ScholarPubMed
Leucht, SPitschel-Walz, GEngel, RRKissling, WAmisulpride, an unusual “atypical” antipsychotic: a meta-analysis of randomized controlled trials. Am J Psychiatry 2002;159:180190CrossRefGoogle ScholarPubMed
Liddle, PFBarnes, TRESyndromes of chronic schizophrenia. Br J Psychiatry 1990;157:558561CrossRefGoogle ScholarPubMed
Lindenmayer, JPKhan, AIskander, AAbad, MTParker, BA randomized controlled trial of olanzapine versus haloperidol in the treatment of primary negative symptoms and neurocognitive deficits in schizophrenia. J Clin Psychiatry 2007;68:368379CrossRefGoogle Scholar
Loo, HPoirier-Littre, MFTheron, MRein, WFleurot, OAmisulpride versus placebo in the medium-term treatment of the negative symptoms of schizophrenia. Br J Psychiatry 1997;170:1822CrossRefGoogle ScholarPubMed
Malaspina, DGoetz, RRYale, SBerman, AFriedman, JHTremeau, FRelation of familial schizophrenia to negative symptoms but not to the deficit syndrome. Am J Psychiatry 2000;157:9941003CrossRefGoogle Scholar
McGlashan, THFenton, WSThe positive-negative distinction in schizophrenia: review of natural history validators. Arch Gen Psychiatry 1992;49:6372CrossRefGoogle ScholarPubMed
Messias, EKirkpatrick, BBromet, ERoss, DBuchanan, RWCarpenter, WT Jr.et al.Summer birth and deficit schizophrenia. a pooled analysis from 6 countries. Arch Gen Psychiatry 2004;61:985989CrossRefGoogle ScholarPubMed
Messias, EKirkpatrick, BSummer birth and deficit schizophrenia in the Epidemiologic Catchment Area study. J Nerv Ment Dis 2001;189:608612CrossRefGoogle Scholar
Minoretti, PPoliti, PCoen, EDi Vito, CBertona, MBianchi, Met al.The T393C polymorphism of the GNAS1 gene is associated with deficit schizophrenia in an Italian population sample. Neurosci Lett 2006;397:159163CrossRefGoogle Scholar
Mucci, AGalderisi, SKirkpatrick, BBucci, PVolpe, UMerlotti, Eet al.Double dissociation of N1 and P3 abnormalities in deficit and non-deficit schizophrenia. Schizophr Res 2007;92:252261CrossRefGoogle Scholar
Murphy, BPChung, Y-CPark, T-WMcGorry, PDPharmacological treatment of primary negative symptoms in schizophrenia: a systematic review. Schizophr Res 2006;88:525CrossRefGoogle ScholarPubMed
Nakaya, MOhmori, KA two-factor structure for the Schedule for the Deficit Syndrome in schizophrenia. Psychiatry Res 2008;158:256259CrossRefGoogle Scholar
Nkam, IThibaut, FDenise, PVan Der Elst, ASégard, LBrazo, Pet al.Saccadic and smooth-pursuit eye movements in deficit and non-deficit schizophrenia. Schizophr Res 2001;48:145153CrossRefGoogle ScholarPubMed
Paillère-Martinot, M-LLecrubier, YMartinot, JLAubin, FImprovement of some schizophrenic deficit symptoms with low doses of amisulpride. Am J Psychiatry 1995;152:130133Google ScholarPubMed
Peralta, Vde Leon, JCuesta, MJAre there more than two syndromes in schizophrenia? A critique of the positive-negative dichotomy. Br J Psychiatry 1992;161:335343CrossRefGoogle ScholarPubMed
Pogue-Geile, MFHarrow, MNegative symptoms in schizophrenia: their longitudinal course and prognostic importance. Schizophr Bull 1985;11:427439CrossRefGoogle ScholarPubMed
Polgár, P, Farkas, M, Nagy, O, Kelemen, O, Réthelyi, J, Bitter, Iet al.How to find the way out from four rooms? The learning of “chaining” associations may shed light on the neuropsychology of the deficit syndrome of schizophrenia. Schizophr Res. 2008;99:200–7.CrossRefGoogle ScholarPubMed
Quarantelli, MLarobina, MVolpe, UAmati, GTedeschi, ECiarmiello, Aet al.Stereotaxy-based regional brain volumetry applied to segmented MRI: validation and results in deficit and non-deficit schizophrenia. NeuroImage 2002;17:373384CrossRefGoogle Scholar
Rey, ERBailer, JBräuer, WHändel, MLaubenstein, DStein, AStability trends and longitudinal correlations of negative and positive syndromes within a three-year follow-up of initially hospitalized schizophrenics. Acta Psychiatr Scand 1994;90:405412CrossRefGoogle ScholarPubMed
Rosenheck, RDunn, LPeszke, MCramer, JXu, WThomas, Jet al.Impact of clozapine on negative symptoms and on the deficit syndrome in refractory schizophrenia. Am J Psychiatry 1999;156:8893CrossRefGoogle ScholarPubMed
Ross, DEKirkpatrick, BKarkowski, LMStraub, REMacLean, CJO’Neill, FAet al.Sibling correlation of deficit syndrome in the Irish study of high-density schizophrenia families. Am J Psychiatry 2000;157:10711076CrossRefGoogle ScholarPubMed
Ross, DEThaker, GKBuchnan, RWKirkpatrick, BLahti, ACMedoff, Det al.Association of abnormal smooth pursuit eye movements with the deficit syndrome in schizophrenic patients. Am J Psychiatry 1997;153:11581165Google Scholar
Sigmundsson, TSuckling, JMaier, MWilliams, SBullmore, EGreenwood, Ket al.Structural abnormalities in frontal, temporal, and limbic regions and interconnecting white matter tracts in schizophrenic patients with prominent negative symptoms. Am J Psychiatry 2001;158:234243CrossRefGoogle ScholarPubMed
Smith, RCKadewari, RPRosenberger, JRBhattacharyya, ANonresponding schizophrenia: differentiation by neurological soft signs and neuropsychological tests. Schizophr Bull 1999;25:813825CrossRefGoogle ScholarPubMed
Strauss, JSCarpenter, WTThe prediction of outcome in schizophrenia. I: characteristics of outcome. Arch Gen Psychiatry 1972;27:739746CrossRefGoogle Scholar
Tamminga, CAThaker, GKBuchanan, RWGao, XShirakawa, OBuchanan, Ret al.Limbic system abnormalities identified in schizophrenia using positron emission tomography with fluorodeoxyglucose and neocortical alterations with deficit syndrome. Arch Gen Psychiatry 1992;49:522530CrossRefGoogle ScholarPubMed
Tandon, RDeQuardo, JRTaylor, SFet al.Phasic and enduring negative symptoms in schizophrenia: biological markers and relationship to outcome. Schizophr Res 2000;45:191201CrossRefGoogle Scholar
Tek, CKirkpatrick, BBuchanan, RWA five-year follow-up study of deficit and non-deficit schizophrenia. Schizophr Res 2001;49:253260CrossRefGoogle Scholar
Tollefson, GDSanger, TMNegative symptoms: a path analytic approach to a double-blind, placebo- and haloperidol-controlled clinical trial with olanzapine. Am J Psychiatry 1997;154:466474Google ScholarPubMed
Turetsky, BCowell, PEGur, RCGrossman, RIShtasel, DLGur, REFrontal and temporal lobe brain volumes in schizophrenia. Relationship to symptoms and clinical subtype. Arch Gen Psychiatry 1995;52:10611070CrossRefGoogle ScholarPubMed
Turetsky, BIColbath, EAGur, REP300 subcomponent abnormalities in schizophrenia: I. Physiological evidence for gender and subtype specific differences in regional pathology. Biol Psychiatry 1998;43:8496CrossRefGoogle ScholarPubMed
Vaiva, GCottencin, OLlorca, PMDevos, PDupont, SMazas, Oet al.Regional cerebral blood flow in deficit/non-deficit types of schizophrenia according to SDS criteria. Prog Neuropsychopharmacol Biol Psychiatry 2002;26:481485CrossRefGoogle Scholar
Vaiva, GThomas, PLlorca, PMDupont, SCottencin, ODevos, Pet al.SPECT imaging, clinical features, and cognition before and after low doses of amisulpride in schizophrenic patients with the deficit syndrome. Psychiatry Res 2002;115:3748CrossRefGoogle ScholarPubMed
Waltrip, RWBuchanan, RWCarpenter, WT Jr.Kirkpatrick, BSummerfelt, ABreier, Aet al.Borna disease virus antibodies and the deficit syndrome of schizophrenia. Schizophr Res 1997;23:253258CrossRefGoogle ScholarPubMed
Wonodi, IMitchell, BDStine, OCHong, LEElliott, AKirkpatrick, Bet al.Lack of association between COMT gene and deficit/non-deficit schizophrenia. Behav Brain Funct 2006;2:42CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.