0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

1
Letter to the Editor   |    
Dr. Kopelowicz and Colleagues Reply
ALEX KOPELOWICZ, M.D.; ROBERTO ZARATE, PH.D.; ROBERT PAUL LIBERMAN, M.D.
Am J Psychiatry 2001;158:825-a-825. doi:10.1176/appi.ajp.158.5.825-a

To the Editor: We thank Dr. Rifkin for his interest in our article. He correctly notes that the deficit group (those with primary negative symptoms) in our study not only failed to show improvement in negative symptoms but also showed no improvement in positive symptoms. In contrast, the nondeficit group (those with secondary negative symptoms) improved in both positive and negative symptoms. Rather than conclude that olanzapine had a differential effect on primary and secondary negative symptoms, he suggests an alternative explanation—namely, that negative symptoms improve only when positive symptoms improve.

Dr. Rifkin anticipates our first response to his alternative interpretation of our results by noting in his letter that, by definition, primary negative symptoms do not come from positive symptoms. However, he claims that this assertion lacks empirical proof. In fact, this assertion has substantial empirical support from a number of studies conducted over the past 15 years by the University of Maryland group (15). Moreover, the results of our own study do not support the conclusion that olanzapine improved negative symptoms only when positive symptoms improved, even in the nondeficit group. In fact, we reported that positive symptom change, by itself, did not predict change in negative symptom score (p. 990). We believe that the most parsimonious explanation for our findings is that 1) olanzapine was effective in treating secondary negative symptoms because of its efficacy for positive symptoms and depressive symptoms, as well as its low propensity to cause extrapyramidal side effects, and 2) primary negative symptoms did not respond to treatment with olanzapine.

Buchanan RW, Kirkpatrick B, Heinrichs DW, Carpenter WT: Clinical correlates of the deficit syndrome of schizophrenia. Am J Psychiatry  1990; 147:290–294
[PubMed]
 
Buchanan RW, Carpenter WT: Domains of psychopathology: an approach to the reduction of heterogeneity in schizophrenia. J Nerv Ment Dis  1994; 182:193–204
[PubMed]
[CrossRef]
 
Carpenter WT, Heinrichs DW, Wagman AM: Deficit and nondeficit forms of schizophrenia: the concept. Am J Psychiatry  1988; 145:578–583
[PubMed]
 
Kirkpatrick B, Castle D, Murray RM, Carpenter WT: Risk factors for the deficit syndrome of schizophrenia. Schizophr Bull  1999; 26:233–242
 
Kirkpatrick B, Kopelowicz A, Buchanan RW, Carpenter WT: Assessing the efficacy of treatments for the deficit syndrome of schizophrenia. Neuropsychopharmacology  2000; 22:303–310
[PubMed]
[CrossRef]
 
+

References

Buchanan RW, Kirkpatrick B, Heinrichs DW, Carpenter WT: Clinical correlates of the deficit syndrome of schizophrenia. Am J Psychiatry  1990; 147:290–294
[PubMed]
 
Buchanan RW, Carpenter WT: Domains of psychopathology: an approach to the reduction of heterogeneity in schizophrenia. J Nerv Ment Dis  1994; 182:193–204
[PubMed]
[CrossRef]
 
Carpenter WT, Heinrichs DW, Wagman AM: Deficit and nondeficit forms of schizophrenia: the concept. Am J Psychiatry  1988; 145:578–583
[PubMed]
 
Kirkpatrick B, Castle D, Murray RM, Carpenter WT: Risk factors for the deficit syndrome of schizophrenia. Schizophr Bull  1999; 26:233–242
 
Kirkpatrick B, Kopelowicz A, Buchanan RW, Carpenter WT: Assessing the efficacy of treatments for the deficit syndrome of schizophrenia. Neuropsychopharmacology  2000; 22:303–310
[PubMed]
[CrossRef]
 
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Books
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 20.  >
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 26.  >
The American Psychiatric Publishing Textbook of Psychiatry, 5th Edition > Chapter 26.  >
APA Practice Guidelines > Chapter 4.  >
APA Practice Guidelines > Chapter 4.  >
Topic Collections
Psychiatric News
Read more at Psychiatric News >>
APA Guidelines
PubMed Articles