Many treatment-refractory patients present with a psychosis that is positive symptom domain responsive, but have symptoms that are non-responsive within the negative or cognitive symptom subdomains and associated circuits. It is now recommended that patients with symptom profiles that do not respond to antipsychotic medication and are considered treatment resistant be identified as: TRS-positive symptom domain-, TRS-negative symptom domain-, and TRS-cognitive symptom domain-specific. For those patients with combined treatment resistance in more than one domain (multidimensional resistance), identifying all of those specific symptom domains will provide further clarification (12).