“It may be that the negative symptoms of schizophrenia, including problems with motivation, social interactions, affective experience and responsiveness, prosody and clarity of speech, and slowed movement, contribute more to poor functional outcomes and quality of life for individuals with schizophrenia than do [psychotic] symptoms.”

– Dawn I. Velligan and Larry D. Alphs, “Negative Symptoms in Schizophrenia: An Update on Identification and Treatment,” Psychiatric Times, November 24, 2014

The question arises: Why have we included the citation so prominently on our Home page?

We’ve done so because it captures in a concise and compelling way the difficulties many of those with serious mental illness face long after their psychosis is under control and they’ve been discharged from hospital. It’s to help people struggling with those difficulties enjoy a better life and be embraced by others that our River Village proposal is being brought forward.

All too often those symptoms are underestimated or ignored by the public. They’re not graphic and troubling like psychosis, such as delusions and hallucinations – now generally controlled by medication. They’re no less disabling in their own way, however, as the citation indicates. Unlike acute-care treatment for psychosis, moreover, which can be relatively brief, the residual negative symptoms of schizophrenia can last, to a greater or lesser degree, for the rest of people’s lives.

The citation refers to schizophrenia. Other major mental illnesses, however, share some of the same symptoms. Avolition, for example – the lack of motivation – is a common symptom of major depression (major depressive disorder). Those with serious bipolar disorder (Bipolar 1) experience, in many cases, a degree of cognitive dysfunction that endures beyond the acute episodes of mania and depression. A higher than average rate of suicides and suicide attempts is common to all of the three illnesses. Serious anxiety, a quite disabling condition in itself, is a common secondary symptom in the other illnesses.

Finally, you may be interested in the terminology used in the citation. The symptoms it details are called “negative symptoms” because they describe something taken away from what was there before the person fell ill. “Positive systems,” the symptoms of psychosis like delusions and hallucinations, are called “positive” not because they’re good to have, but because they’re additions to what was there before the illness struck.

Related articles

Herschel Hardin, “Riverview Village aims to improve quality of life for mentally ill,” Vancouver Sun, July 17, 2017.

Dawn I. Velligan and Larry D. Alphs, “Negative Symptoms in Schizophrenia: An Update on Identification and Treatment,” Psychiatric Times, November 24, 2014