The reason being that patients who are diagnosed with deficit syndrome are more likely to experience primary enduring blunted affect symptoms 3. It is therefore suggested by Kirkpatrick 3 that the Schedule for Deficit Syndrome be considered in conjunction with negative symptoms instruments in order to assist in determining whether blunted affect symptoms are primary or secondary. Also, antipsychotic medications as well as antidepressants can cause secondary blunted affect 9. Symptoms such as lack of facial expression, apathy and psychomotor slowing are often associated with both. In schizophrenia, blunted affect closely resembles symptoms of depression making it difficult to distinguish between the two in the absence of appropriate instruments 10. Blunted affect can be a feature of both primary and secondary negative symptoms 3.

For example, blunted affect can co-vary with the negative symptom alogia 9, but whether these symptoms involve the same or a different neurobiological basis remains unanswered. There are many factors that should be considered when assessing blunted affect.

In all of these disorders the fronto-striatal reward pathways are thought to play a role in producing blunted affect 8. Also, antipsychotic-induced parkinsonism, which has a similar clinical presentation as Parkinson’s disease, may cause blunted affect which is clinically indistinguishable from blunted affect due to schizophrenia. In degenerative disorders such as Parkinson’s disease, blunted affect is frequently a prominent symptom. While blunted affect is an integral component of the symptom expression of the illness it is not unique to schizophrenia 1.

However, patients’ reduced outward emotional expression may not mirror subjective internal emotional experiences 5 suggesting a disconnect in what patients experience, perceive and express when interpreting emotional stimuli 6 due to problems associated with emotional processing 7. Patients with blunted affect have difficulty in expressing their emotions 3, characterized by diminished facial expression, expressive gestures and vocal expressions in reaction to emotion provoking stimuli 4. Blunted affect is regarded as a negative symptom of schizophrenia and like other negative symptoms, the assessment, treatment and overall understanding of blunted affect remains limited 2. Blunted affect is a prominent symptom of schizophrenia. Blunted affect vs flat affect What is blunted affectīlunted affect also referred to as flat affect, emotional blunting or a decrease in the observed expression of emotion 1.

What is flat affect