Negative symptoms and their association with depressive symptoms in the long-term course of schizophrenia

  • Wolfram an der Heiden
  • Anne Leber
  • Heinz Häfner
Original Paper


Depressive symptoms abound in schizophrenia and even in subclinical states of the disorder. We studied the frequency of these symptoms and their relationship to negative symptoms from the first psychotic episode on over a long-term course of 134 months on data for 107 patients in our ABC Schizophrenia Study. Prevalence rates of 90 % for presenting at least one negative symptom and of 60 % for presenting at least one depressive symptom in the first psychotic episode illustrate the frequency of these syndromes. After the remission of psychosis the rates fell to 50 % (negative symptoms) and 40 % (depressive symptoms) over a period of 5 years, remaining stable thereafter. After we broke the negative syndrome down into (SANS) subsyndromes, a positive association emerged between anhedonia and depressive symptoms and remained stable over the entire period studied. In contrast, the association between abulia and depression grew increasingly pronounced over the illness course. However, a more detailed look revealed this to be the case in female patients only, whereas male patients showed no such association of these symptom dimensions. We have no explanation at hand for this sex difference yet.


Schizophrenia Depressive symptoms Negative symptoms Long-term course Sex differences 



The ABC Schizophrenia Study was funded by the German Research Foundation (DFG) as part of the Special Research Branch (Sonderforschungsbereich) 258 at the Central Institute of Mental Health from 1 January 1987 to 30 December 1998 and from 1 January 1999 to 31 May 2012 as an independent project.

Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interests in relation to the subject of this study.

Ethical standards

All human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Wolfram an der Heiden
    • 1
  • Anne Leber
    • 1
  • Heinz Häfner
    • 1
  1. 1.Schizophrenia Research Group, Central Institute of Mental HealthHeidelberg University/Medical Faculty MannheimMannheimGermany

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