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Unit for Social and Community Psychiatry

Negative symptoms in schizophrenia


Negative symptoms of schizophrenia include reduced emotional expression, social withdrawal, blunted affect an inability to anticipate pleasure and a lack of initiative. These symptoms have been found to have a greater impact of social functioning and quality of life in comparison to other symptoms, and be highly resistant to both drug and talking treatments.

In an attempt to improve patient outcomes in this area, a report was published in 2006 proposing ways to address some of the barriers which may be impeding treatment development. Amongst the issues identified included how we currently assess negative symptoms, and a lack of understanding around symptom occurrence, longitudinal course, and the relationship between individual negative symptoms. The focus of this PhD will be to attempt to address some of these concerns.

Research questions

  • Do negative symptoms change over time, and if so, how?
  • Are some negative symptoms more liable to change than others?
  • What is the stability and occurrence of these symptoms in typical outpatient samples?
  • Have developments in negative symptom assessment translated into more sensitive and valid instruments?
  • How do our clinical assessments of negative symptoms relate to real-world outcomes?

Research activities

  • A systematic review has been conducted to look at how negative symptoms change over time in stable outpatients with schizophrenia.
  • Using existing datasets, we have re-examined the stability and prevalence of negative symptoms in a large outpatient sample.
  • Different scales designed to measure negative symptoms have been compared in terms of how sensitive they are to detect change, and how well they predict different features of social impoverishment.
  • The link between negative symptoms and subjective quality of life has been further explored.
  • How negative symptoms affect the appraisal of inpatient treatment immediately following admission has been examined.


Conclusions are expected on completion of this project in late 2015.


Mark Savill

Associated papers

Savill, M., C. Banks, H. Khanom, and S. Priebe. Do negative symptoms of schizophrenia change over time? A meta-analysis of longitudinal data. Psychological medicine (2014): 1-15.

Savill, Mark, Jelena Jankovic, Christina Katsakou, Thomas Kallert, and Stefan Priebe. "Symptom levels and initial appraisal of hospital treatment in patients with schizophrenia." Psychiatry research 199, no. 2 (2012): 79-83.

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