Which diagnosis is most likely if there are prominent negative symptoms and disorganized speech along with psychotic features?

• A. Delusional Disorder
• B. Major Neurocognitive Disorder
• C. Schizophrenia
• D. Substance/Medication-Induced Psychotic Disorder

Answer: (C)

A pattern of prominent negative symptoms along with disorganized speech and active psychotic features is characteristic of schizophrenia. Negative symptoms—such as diminished emotional expression, avolition, and alogia—reflect reduced motivation and expression, while disorganized speech shows disorganized thinking. Together with psychotic symptoms like delusions or hallucinations, this combination aligns with a primary schizophrenia spectrum disorder.

Delusional disorder typically features delusions without substantial disorganization or negative symptoms. Major neurocognitive disorder centers on decline in cognitive function (memory, attention, executive function) with psychotic features not being the defining pattern. Substance/medication-induced psychotic disorder requires a temporal link to a substance and often does not present with the pronounced negative symptoms and disorganized speech described here.