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If someone has almost all of the negative symptoms of schizophrenia, and no positive symptoms of schizophrenia whatsoever, is that enough to be diagnosed with a mental disorder?

I understand that a diagnosis of schizophrenia is not possible with only negative symptoms.

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  • $\begingroup$ I have edited the post but feel free to roll these changes back. Personally, I think it is entirely irrelevant to the question whether someone has a strong libido yes or no. $\endgroup$
    – AliceD
    Mar 27, 2018 at 19:20
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    $\begingroup$ It seems more accurate to remove it so the question won't be narrowed, I just thought it might be relevant to the specific case $\endgroup$
    – user18817
    Mar 27, 2018 at 19:27
  • $\begingroup$ Thanks for the feedback. Self-help questions are explicitly off-topic here, which was another reason to remove it to generalize it. I think it's a great question now. +1 $\endgroup$
    – AliceD
    Mar 27, 2018 at 19:30
  • $\begingroup$ You will find that diagnoses are rarely applied in strictly tabular way - if this and this then that. So for your theoretical question it would help to list the symptoms as bulletpoints and if you can in brackets the most extreme example of that symptom. $\endgroup$
    – r0berts
    Mar 28, 2018 at 12:43

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Short answer
Many people in the general populace suffer one or more negative symptoms that are associated with schizophrenia, but are not diagnosed with a mental illness whatsoever.

Background
Indeed, for a diagnosis of schizophrenia, negative symptoms alone are not enough. According to the Diagnostic and Statistical Manual of Mental Disorders, (DSM-5), to meet the criteria for diagnosis of schizophrenia, the patient must have experienced at least 2 of the following symptoms:

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Disorganized or catatonic behavior
  • Negative symptoms

Werbeloff et al. (2015) note that, similar to psychotic experiences, negative symptoms are common in the general population, namely between 20–22%. The vast majority of these people do not manifest a clinically diagnosed psychiatric disorder. Negative symptoms do appear to be associated with the development of schizophrenia later in life, and to other non-psychotic disorders. However, neither negative symptoms nor psychotic experiences alone predicted later schizophrenia in their study. It was only the combined presence of both strong positive psychotic experiences and negative symptoms together that showed a statistically significant risk for later schizophrenia.

Reference
- Werbeloff et al., PLoS One (2015); 10(3): e0119852

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  • $\begingroup$ I read most of that study, and it seems that although ~20% of the population have 1 or more negative symptom, each negative symptom is found only in ~0.5%-~2.5% of the population (Table 2). So I wonder what it means to have almost all of them. $\endgroup$
    – user18817
    Mar 27, 2018 at 20:13
  • $\begingroup$ @JimmySmith - valid question and I honestly don't know. Perhaps others can jump in $\endgroup$
    – AliceD
    Apr 3, 2018 at 8:25

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