There are several problems with such an approach. First, existing reports have not agreed on the identifiable secondary negative symptoms, with one study specifying only extrapyramidal and positive symptoms (6), whereas others have addressed these as well as depressive symptoms (5, 7). A second difficulty involves the possibility that other sources of secondary negative symptoms exist. For example, neurocognitive impairment is a common feature in schizophrenia and may be integrally related to negative symptoms (8, 9). While there are reports suggesting that novel antipsychotics are superior to conventional neuroleptics with respect to cognitive measures (10, 11), studies have not yet evaluated the potential impact that they could have on negative symptoms. Any investigation that omits variables that might contribute to secondary negative symptoms risks the possibility of erroneously attributing these changes to an influence on primary symptoms.