Despite advances in the last decade, people with schizophrenia remain disabled by negative symptoms and function poorly in community settings. Until recently negative symptoms were neglected as a treatment target despite apparent recognition of their importance among clinicians.

To examine the impact of negative symptoms on psychosocial functioning in order to assess the importance of such symptoms as a potential treatment target.

295 community based participants with DSM4R schizophrenia were recruited in 11 different European centres and assessed using the following scales: PANSS, GAF, Personal and Social Performance (PSP), Quality of Life Scale (QLS), Functional Recovery Scale in Schizophrenia (FRSS) and PsychoSocial Remission in Schizophrenia (PSRS). Relationships between and negative symptoms and functionality were examined using standard statistical approaches.

In this European cohort negative symptom scores were highly correlated with poor psychosocial functioning in participants living in the community. This significant trend occurred across different scales for measuring functional assessment.

The pharmacological treatment of schizophrenia appears rather becalmed at present. First and second generation antipsychotics appear to have similar efficacy for positive symptoms, different side effect profiles, but little impact on negative symptoms. This study shows a close relationship between negative symptoms and psychosocial functioning: high negative symptom scores are associated with poor functioning. This work supports the view that negative symptoms are a key target for drug development with significant potential benefit for the functioning of individuals. Drug development will increasingly focus on negative symptoms and develop effective adjunctive medication used with existing antipsychotics.