The expression 'deficit schizophrenia' refers to a patient subgroup whose illness is characterized by persistent primary negative symptoms. Differences have been found in clinical, historical, and biological variables between patients with and without deficit schizophrenia. Dr. Galderisi reported on the Italian Multicenter Study, which attempted to characterize deficit schizophrenia by interrelating clinical data with information on changes in brain structure, genetic data, and neuropsychological function.

The study enrolled 60 patients diagnosed with deficit schizophrenia, 60 age- and sex-matched people with a DSM-IV diagnosis of schizophrenia who did not meet the criteria for deficit schizophrenia, and 120 healthy controls. Each participant completed a history and had psychological assessment, neurological and neuro-psychobiological testing, and X-rays of the head and brain. Blood samples were also taken from patients and controls to study the association between deficit schizophrenia and the genes encoding for brain growth factors.

Dr. Galderisi found differences in measures between patients with deficit schizophrenia and those with non-deficit schizophrenia. Patients with deficit schizophrenia had an increase in negative symptoms, poor attention, more severe neurological impairment, and worse personal adjustment before the first episode of schizophrenia.

Of special interest were significant differences in anergia measurements among patients with deficit schizophrenia. Patients with deficit schizophrenia also showed much lower levels of hostility on the tests. Results from the childhood behavior scale that asked the mother to compare the patient with the nearest sibling (preferably of the same age) indicated that some changes were detectable as early as childhood.

Dr. Galderisi asserted that the findings suggest that most of the differences between the two patient populations may be explained by the neurological and premorbid measures, both of which suggest that deficit schizophrenia is different from non-deficit schizophrenia.

She concluded that new evidence demonstrating multple differences between patients with and without deficit schizophrenia might allow development of new psychosocial interventions and pharmacologic treatments.