OBJECTIVES: Patients with schizophrenia often remain symptomatic with predominant negative symptoms (PNS) despite receiving antipsychotic therapy. Several definitions of PNS are published in the literature. The purpose of this study is to compare evolution of patients with and without PNS over time, and to explore the predictive status of PNS in terms of quality of life, depression and resource use, considering several definitions. METHODS: Fifteen definitions of PNS were retrieved from literature, out of which 3 were applied in a longitudinal cohort of patients with schizophrenia (N=1208). Clinical characteristics, depression, functioning, medication, quality of life and resource utilization were assessed at baseline and at 6 months, and compared between subgroups of patients (with/out PNS at baseline and at 6 months). Reasons of PNS status change were described for each definition. Regression models were used to explore the predictive status of PNS in terms of quality of life, depression and resource use. RESULTS: According to the 3 definitions used, severity of positive symptom significantly increased in patients with PNS at baseline but not at 6 months. Negative symptoms decreased to a lesser extent. Patient functioning, depression, medication, quality of life and resource utilization evolution were not consistent across definitions. According to all the definitions, PNS status at baseline was associated with change from baseline in terms of depression, quality of life, number of GP visits and number of hospitalization days, when adjustments were taken into account.  CONCLUSIONS: Our study suggests that PNS status at a specific time point is associated with depression, quality of life and resource utilization evolution at 6 months. Results also show that patients with PNS at a specific time point not showing PNS 6 months later are not associated with better outcomes. This confirms that schizophrenic patients with PNS form a severe population, and required further analyses.