Dopamine dysregulation and altered energy metabolism are established features of schizophrenia individually linked to illness severity but also exhibiting a complex mutual relationship. How these two facets of the underlying pathophysiology contribute to the varied symptoms of the disorder is still not well understood. Given the likely systemic nature of schizophrenia, we hypothesized that combined measures of dopamine and metabolic function would prove better correlates for relevant psychopathology than either of the measures alone.This possibility was investigated in a previously published dataset of 15 patients with first episode psychosis (10m, 5f) who underwent positron emission tomography using the selective dopamine D2/3 receptor agonist radioligand [11C]-(+)-PHNO. Regional [11C]-(+)-PHNO binding potentials were divided by each of the peripheral metabolic parameters (glucose, triglycerides, total, LDL, and HDL cholesterol) sampled immediately prior to the scan.The ratios of subcortical [11C]-(+)-PHNO binding potentials to glucose, total and LDL cholesterol displayed significant and largely non-overlapping associations with a range of negative and general symptoms as measured by the positive and negative syndrome scale (PANSS), including blunted affect, emotional withdrawal, and unusual thought content (-0.5> r >0.5 ). These results were corroborated using voxel-based analyses (p< 0.05, false discovery rate corrected).The use of simple dopamine/metabolic ratios uncovered clinically relevant relationships hitherto observed only under challenge conditions or in very large patient cohorts. The high specificity of the measures for individual symptoms further demonstrates the potential of relational approaches for linking neurobiology to the clinical presentation of schizophrenia.