**Question:** Negative symptoms of schizophrenia is

A. Atypical motor behavior
B. Delusions and hallucinations
C. Altered mood and affect
D. Social withdrawal and anhedonia

**Correct Answer:** D. Social withdrawal and anhedonia

**Core Concept:** Negative symptoms of schizophrenia are a group of signs and symptoms that characterize the absence or deficit of normal psychological functions. In schizophrenia, these symptoms negatively impact the patient's social interaction, motivation, and pleasure experience.

**Why the Correct Answer is Right:**

D. Social withdrawal and anhedonia are considered the core negative symptoms in schizophrenia. Social withdrawal refers to the patient's reduced engagement in social activities, leading to isolation and reduced social interaction. Anhedonia, on the other hand, is the inability or reduced ability to experience pleasure or enjoyment from previously pleasurable activities, contributing to a flat or blunted affect. These negative symptoms are distinct from positive symptoms (hallucinations and delusions) and cognitive symptoms (executive dysfunction) and are essential to evaluate in patients with schizophrenia as they significantly affect the patient's quality of life.

**Why Each Wrong Option is Incorrect:**

A. Atypical motor behavior (option A) is not a negative symptom but rather a positive symptom, characterized by unusual motor behavior, such as stereotyped movements, poverty of speech, or waxy flexibility.

B. Delusions and hallucinations (option B) are positive symptoms related to the patient's perception and belief, not negative symptoms. Negative symptoms impact the patient's experience, behavior, and emotions.

C. Altered mood and affect (option C) may be considered a positive symptom, as it refers to changes in the patient's emotional state, which is different from negative symptoms that affect the patient's motivation, social interaction, and pleasure experience.

**Clinical Pearl:** Negative symptoms in schizophrenia can have a significant impact on the patient's daily functioning, employment, and overall well-being. A comprehensive evaluation of negative symptoms is crucial in formulating an accurate diagnosis and developing an effective treatment plan for the patient.