Negative symptoms as such are etiologically neutral, however considering them as a group of symptoms in a given context of personality, type of psychotic disease, coping with the disease and reactions of others to the symptoms, enables the clinician to make meaningful differences.

Combining existing clinical distinctions and certain aspects that emerge in clinical practice, the authors describe five types of patients with psychotic disorders and negative symptoms. They are successively characterised by social withdrawal, by demoralisation caused by a psychotic disorder, and by `normal behaviour deficits' associated with persistent psychosis. The authors comment on the position of depressive symptomatology and the unwanted side-effects of anti-psychotic drugs.