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Comments and Controversies

Negative symptoms

Vol. 10, No. 11 / November 2011

I read and enjoyed Dr. Nasrallah’s excellent summary of schizophrenia symptoms in “The primary and secondary symptoms of schizophrenia: Current and future management” (Current Psychiatry, supplement to September 2011, p. S5-S9).

I have a suggestion to add to the list of secondary negative symptoms based only on my observations: demoralization caused by repeated failures in all dimensions—self, interpersonal, social, and industrial. I have seen demoralization in schizophrenia patients manifest as low self-esteem, hopelessness, apathy, and self reproach.

Robert A. Williams, MD
Biological Psychiatry Institute, Ltd.
Phoenix, AZ

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