Are There Two Types of Schizophrenia? True Onset and Sequence of Positive and Negative Syndromes Prior to First Admission

Abstract

The distinction between positive and negative symptoms, which has been postulated in different contexts by Fish (1962), Wing and Brown (1970), Andreasen and Olsen (1982), Crow (1980a, b, 1985) and others, dates back to Reynolds (1858). Jackson (1889) applied it to his speculative system of a hierarchical structure of brain functions. He assumed that negative symptoms were due to functional losses of the brain caused by the illness, whereas positive symptoms were the expression of still healthy brain tissues activated by functional deficits of the higher levels. Kraepelin’s (1909–1915) assumption that there are four sub-types of schizophrenia, from dementia simplex with purely negative symptomatology and proceeding continuously towards the defect, to paranoid-hallucinatory schizophrenia with mainly positive symptomatology, paved the way for various dichotomous concepts of schizophrenia.