Background: Studies of the relationship between negative symptoms, neuropsychological impairments and neurological signs in schizophrenia have yielded inconsistent results. In addition, little attention has been directed to address the extent of cultural modulation of negative symptoms.
Method: We carried out cross-cultural validation of the High Royds Evaluation of Negativity Scale (HEN) in 50 Hong Kong Chinese patients with schizophrenia. We then investigated the relationship between negative symptoms, neurological signs and neuropsychological impairment in 204 patients.
Results: Good interrater reliability, internal reliability, convergent and discriminant validity were found with the HEN. The HEN contained four factors corresponding to 'behaviour', 'functioning', 'thought' and 'appearance'. Negative symptoms were correlated with semantic fluency but not with Wisconsin Card Sorting Test performance or sustained attention. Negative symptoms were also correlated with tardive dyskinesia and catatonia but not with soft neurological signs.
Conclusions: Cross-cultural robustness of the negative symptoms construct is supported. Association of negative symptoms with a specific profile of neurocognitive impairment suggests diversity within deficit domains in schizophrenia.