BACKGROUND The clinical significance in schizophrenia of positive and negative symptoms at discharge was assessed.
METHOD 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.