Schizophrenia is a complex psychiatric disorder characterized by the presence of positive and negative symptoms as well as a wide range of cognitive and social functioning impairments. Recent findings suggest that negative symptoms, such as avolition, anhedonia, asociality, alogia, and affective blunting, are strongly correlated with clinical and functional outcomes. Unfortunately, these symptoms usually respond poorly to conventional treatment. Recent findings also suggest these symptoms are not just present in patients with schizophrenia and individuals at risk of developing psychosis, similar symptom-like behaviours are also observed in general population. However, it is still not clearly known for the origins and mechanisms of negative symptoms, and a thorough study of these symptoms can definitely advance the development of effective early identification and precision interventions.

Dr. Raymond Chan from the Neuropsychology and Applied Cognitive Neuroscience (NACN) Laboratory, Institute of Psychology, Chinese Academy of Sciences and his collaborator have critically reviewed and outlined the important points of convergence for evidence gathered at the phenomenology and neurobiology levels of schizophrenia, ranging from the evolving conceptualization of negative symptoms to development of innovation intervention for negative symptoms. More importantly, they have proposed a new model to synthesize and articulate the factors contributing to the development of negative symptoms observed in clinical and subclinical populations. They also argue that negative symptoms apparently bear a trait with state-elevation property, that is, these symptoms may present long before onset of psychosis but would temporally worsen shortly before the occurrence of a psychotic episode. This new perspective shed light on the understanding of negative symptoms in both clinical and subclinical populations. Finally, they advocate that future research should capture inter-individual difference of intra-individual variability of negative symptoms, using sophisticated technology and longitudinal designs to revolutionize the ways we assess and manage negative symptoms.

The preparation of this review was supported by the CAS Key Laboratory of Mental Health, Institute of Psychology and the Philip K. H. Wong Foundation.

This review entitled "Theories and models of negative symptoms in schizophrenia and clinical implications" is now published online in Nature Reviews Psychology.

LIU Chen
Institute of Psychology
Chinese Academy of Sciences
Beijing 100101, China.
E-mail: liuc@psych.ac.cn