Think PLANT to recall vegetative symptoms

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Think PLANT to recall vegetative symptoms

Obvious positive symptoms of schizophrenia—such as hallucinations and delusions—typically prompt treatment, but positive symptoms may be absent or clouded by the rationalizations and minimization often seen in paranoia. Negative symptoms can also escape detection because of their subtlety.

Andreasen and Olson’s criteria for negative symptoms1 provide the basis for the Schedule for the Assessment of Negative Symptoms (SANS) that includes the five As: avolition/apathy, alogia, affective flattening, anhedonia/asociality, and attentional impairment.

Many remember Bleuler’s four As of schizophrenia—autism, loosening of associations, affective disturbances, and ambivalence—but may have a harder time remembering the SANS’ five As. I find the pseudo-acronym PLANT (for the vegetative changes manifested with negative symptoms) helpful for recalling all five As (Table).

Table

Use PLANT pseudo-acronym to recall vegetative symptoms

SymptomMeaningExamples
aPathy/avolitionLack of drivePoor grooming
Anergia
Impersistence
aLogiaMarked impairment in thought processing and/or contentPoverty of speech
Poverty of content
Thought blocking
Latency of response
Poor abstracting
Affective disturbancesAltered expressivenessPoor eye contact
Aprosodic speech
Lack of expression
Poverty of gestures
aNhedonia/
asociality
Loss of interests and pleasuresLittle interest in sex
Lack of closeness
Few friends
Poor capacity for rapport
aTtentional impairmentInattentivenessPoor concentration
Stereotyped thought
References

1. Andreasen N, Olson SC. Negative versus positive schizophrenia: definition and validation. Arch Gen Psych 1982;39:789-94.

Dr. Wagner is assistant clinical professor, Indiana University School of Medicine, and staff psychiatrist, Richard L Roudebush VA Medical Center, Indianapolis.

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Obvious positive symptoms of schizophrenia—such as hallucinations and delusions—typically prompt treatment, but positive symptoms may be absent or clouded by the rationalizations and minimization often seen in paranoia. Negative symptoms can also escape detection because of their subtlety.

Andreasen and Olson’s criteria for negative symptoms1 provide the basis for the Schedule for the Assessment of Negative Symptoms (SANS) that includes the five As: avolition/apathy, alogia, affective flattening, anhedonia/asociality, and attentional impairment.

Many remember Bleuler’s four As of schizophrenia—autism, loosening of associations, affective disturbances, and ambivalence—but may have a harder time remembering the SANS’ five As. I find the pseudo-acronym PLANT (for the vegetative changes manifested with negative symptoms) helpful for recalling all five As (Table).

Table

Use PLANT pseudo-acronym to recall vegetative symptoms

SymptomMeaningExamples
aPathy/avolitionLack of drivePoor grooming
Anergia
Impersistence
aLogiaMarked impairment in thought processing and/or contentPoverty of speech
Poverty of content
Thought blocking
Latency of response
Poor abstracting
Affective disturbancesAltered expressivenessPoor eye contact
Aprosodic speech
Lack of expression
Poverty of gestures
aNhedonia/
asociality
Loss of interests and pleasuresLittle interest in sex
Lack of closeness
Few friends
Poor capacity for rapport
aTtentional impairmentInattentivenessPoor concentration
Stereotyped thought

Obvious positive symptoms of schizophrenia—such as hallucinations and delusions—typically prompt treatment, but positive symptoms may be absent or clouded by the rationalizations and minimization often seen in paranoia. Negative symptoms can also escape detection because of their subtlety.

Andreasen and Olson’s criteria for negative symptoms1 provide the basis for the Schedule for the Assessment of Negative Symptoms (SANS) that includes the five As: avolition/apathy, alogia, affective flattening, anhedonia/asociality, and attentional impairment.

Many remember Bleuler’s four As of schizophrenia—autism, loosening of associations, affective disturbances, and ambivalence—but may have a harder time remembering the SANS’ five As. I find the pseudo-acronym PLANT (for the vegetative changes manifested with negative symptoms) helpful for recalling all five As (Table).

Table

Use PLANT pseudo-acronym to recall vegetative symptoms

SymptomMeaningExamples
aPathy/avolitionLack of drivePoor grooming
Anergia
Impersistence
aLogiaMarked impairment in thought processing and/or contentPoverty of speech
Poverty of content
Thought blocking
Latency of response
Poor abstracting
Affective disturbancesAltered expressivenessPoor eye contact
Aprosodic speech
Lack of expression
Poverty of gestures
aNhedonia/
asociality
Loss of interests and pleasuresLittle interest in sex
Lack of closeness
Few friends
Poor capacity for rapport
aTtentional impairmentInattentivenessPoor concentration
Stereotyped thought
References

1. Andreasen N, Olson SC. Negative versus positive schizophrenia: definition and validation. Arch Gen Psych 1982;39:789-94.

Dr. Wagner is assistant clinical professor, Indiana University School of Medicine, and staff psychiatrist, Richard L Roudebush VA Medical Center, Indianapolis.

References

1. Andreasen N, Olson SC. Negative versus positive schizophrenia: definition and validation. Arch Gen Psych 1982;39:789-94.

Dr. Wagner is assistant clinical professor, Indiana University School of Medicine, and staff psychiatrist, Richard L Roudebush VA Medical Center, Indianapolis.

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