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Am J Psychiatry 1994; 151:1417-1422
Copyright © 1994 by American Psychiatric Association
The deficit state in first-episode schizophrenia
DI Mayerhoff, AD Loebel, JM Alvir, SR Szymanski, SH Geisler, M Borenstein and JA Lieberman
Hillside Hospital, Division of Long Island Jewish Medical Center, N.Y. 11004.
OBJECTIVE: The prevalence, clinical correlates, and outcome of the deficit
syndrome were determined for 70 patients ascertained in their first episode
of schizophrenia and then followed through their recovery. METHODS:
Patients were treated in a standardized manner and underwent baseline
assessments of symptoms and adverse effects that were repeated at intervals
throughout their inpatient and subsequent outpatient course. Forty-seven
patients were followed for a minimum of 6 months after remission of their
positive symptoms, allowing for an assessment of their deficit syndrome
status. RESULTS: Using modified criteria of Carpenter et al. for the
deficit syndrome, the authors found that two patients (4%) met all criteria
for the deficit syndrome, nine (19%) had deficit symptoms (questionable
deficit state), and 36 (77%) had no deficit symptoms. When patients who had
not fully remitted or had remitted for less than 6 months were included,
seven (10%) met deficit syndrome criteria, 11 (16%) had deficit symptoms,
and 52 (74%) had no deficit symptoms. CONCLUSIONS: The prevalence of the
deficit syndrome in first-episode schizophrenia varies depending on the
criteria used and is lower than that previously described in more chronic
patient samples. Patients without deficit symptoms had better premorbid
functioning and a better global outcome than patients with deficit
symptoms.
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