The topic will be negative symptoms of schizophrenia, called this because they take away from or reduce functioning. Negative symptoms involve lack of motivation, social withdrawal, blunt affect, and alogia (poverty of speech or poverty of content of speech) and diminished movement.
Positive symptoms such as delusions, paranoia and hallucinations can mostly be managed and are often the focus of treatment sessions. Yet the negative symptoms are the ones that result in poor functional outcomes and worse quality of life.
Negative symptoms are harder to treat and last longer than positive symptoms. (Psychiatric Times. Negative Symptoms in Schizophrenia: The Importance of Identification and Treatment, retrieved April 3, 2012 from http:www.psychiatrictimes.com/schizophrenia/content/article/10168/)
Their improvement can result in better skills in independent living, social functioning and role functioning. The atypical medications do not treat negative symptoms.
Psychiatrists need to inquire about their patient's daily activity and interaction with others. The goal is to determine if the individual engages in productive activity in the daytime.
According to the Psychiatric Times review, "If negative symptoms are related to depressed affect, treatments for depression could be considered. While there is no clear evidence that depression in schizophrenia responds to SSRIs, there is some evidence that SSRIs can have a positive impact on negative symptoms."
It can sometimes be that the urgency of positive symptoms, like hearing voices, causes social withdrawal. In this instance, the Psychiatric Times review states that "increasing the dosage of antipsychotic medication or switching to a different antipsychotic may be warranted."
The atypical drugs might not necessarily improve negative symptoms, yet individuals who take the drugs are more likely to engage in psychosocial treatment, thus the negative symptoms are minimized.
This key benefit could occur with social skills training, so a psychiatrist would do well to refer his patients there when they exhibit negative symptoms.
One good way to assess whether your loved one has negative symptoms is to compare and contrast their personality before their breakdown and how their life is after it. If your son or daughter or husband or wife had more energy and vitality pre-diagnosis, and now has no desire to go to the grocery store, that could indicate negative symptoms are present.
You need to differentiate between whether their "laziness" is a symptom, or whether they were always couch potatoes long before they got sick.
Often, negative symptoms predate the occurrence of positive symptoms and arrive in the prodromal stage of schizophrenia (Medscape, State-of-the Art Treatment for Negative Symptoms of Schizophrenia, retrieved on April 3, 2012 from http://www.medscape.org/viewarticle/560657).
Social skills training can improve competence in relationships, work, recreation and self-care. This kind of training helps individuals express their feelings and adjust their voices and facial expressions. (The Harvard Medical School Family Health Guide, the negative symptoms of schizophrenia. Retrieved on April 3, 2012 from http://www.health.harvard.edu/fhg/updates/update0706c.shtml.)