| 1 | Med. Hypotheses 2010 Jan 74: 142-4 |
|---|---|
| PMID | 19651477 |
| Title | Schizophrenia, brain disease and meta-analyses: integrating the pieces and testing Fusar-Poli's hypothesis. |
| Abstract | This paper aims to discuss and test the hypothesis raised by Fusar-POLI[Fusar-POLIP. Can neuroimaging prove thatschizophreniais a brain disease? A radical hypothesis. Medical Hypotheses in press, corrected proof] that "on the basis of the available imaging literature there is no consistent evidence to reject the radical and provocative hypothesis thatschizophreniais not a brain disease". To achieve this goal, all meta-analyses on 'fMRI andschizophrenia' published during the current decade and indexed in Pubmed were summarized, as much as some other useful information, e.g., meta-analyses on genetic risk factors. Our main conclusion is that the literature fully supports the hypothesis thatschizophreniais a syndrome (not a disease) associated with brain abnormalities, despite the fact that there is no singular and reductionist pathway from the nosographic entity (schizophrenia) to its causes. This irreducibility is due to the fact that the syndrome has more than one dimension (e.g., cognitive, psychotic and negative) and each of them is related to abnormalities in specific neuronal networks. A psychiatric diagnosis is a statistical procedure; these dimensions are not identically represented in each diagnosticated case and this explains the existence of more than one pattern of brain abnormalities related toschizophrenia. For example, chronification is associated with negativism while the first psychotic episode is not; in that sense, the same person living withschizophrenia可以显示不同的症状和功能磁共振成像模式职能ong the course of his life, and this is precisely what definesschizophreniasince the time when it was called Dementia Praecox (first by pick then by Kraepelin). It is notable that 100% of the collected meta-analyses on 'fMRI andschizophrenia' reveal positive findings. Moreover, all meta-analyses that found positive associations betweenschizophreniaand genetic risk factors have to do with genes (SNPs) especially activated in neuronal tissue of the central nervous system (CNS), suggesting that, to the extent these polymorphisms are related toschizophrenia's etiology, they are also related to abnormal brain activity. |
| SCZ Keywords | schizophrenia, schizotypal |
| 2 | Schizophr. Res. 2013 Oct 150: 31-5 |
| PMID | 23773295 |
| Title | Attenuated psychosis syndrome in DSM-5. |
| Abstract | Despite advances in the treatment ofschizophreniaover the past half-century, the illness is frequently associated with a poor outcome. This is principally related to the late identification and intervention in the course of the illness by which time patients have experienced a substantial amount of socio-occupational decline that can be difficult to reverse. The emphasis has therefore shifted to defining psychosis-risk syndromes and evaluating treatments that can prevent transition to psychosis in these ultra-high risk groups. To consider the appropriateness of adding psychosis risk syndrome to our diagnostic nomenclature, the psychotic disorders work group extensively reviewed all available data, consulted a range of experts, and carefully considered the variety of expert and public comments on the topic. It was clear that reliable methods were available to define a syndrome characterized by sub-threshold psychotic symptoms (in severity or duration) and which was associated with a very significant increase in the risk of development of a full-fledged psychotic disorder (schizophreniaspectrum, psychotic mood disorder, and other psychotic disorders) within the next year. At the same time, the majority of individuals with "attenuated psychotic symptoms" had one or more other current psychiatric comorbid conditions (usually mood or anxiety disorders, substance use disorder; Fusar-POLI2012) and exhibited a range of psychiatric outcomes other than conversion to psychosis (significant proportions either fully recover or develop some other psychiatric disorder, with a minority developing a psychotic disorder). Although the reliability of the diagnosis is well established in academic and research settings, it was found to be less so in community and other clinical settings. Furthermore, the nosological relationship of attenuated psychosis syndrome (APS) toschizotypalpersonality disorder and other psychiatric conditions was unclear. Further study will hopefully resolve these questions. The work group decided to recommend the inclusion of attenuated psychosis syndrome as a category in the appendix (Section 3) of DSM-5 as a condition for further study. |
| SCZ Keywords | schizophrenia, schizotypal |
| 3 | Schizophr. Res. 2013 Oct 150: 31-5 |
| PMID | 23773295 |
| Title | Attenuated psychosis syndrome in DSM-5. |
| Abstract | Despite advances in the treatment ofschizophreniaover the past half-century, the illness is frequently associated with a poor outcome. This is principally related to the late identification and intervention in the course of the illness by which time patients have experienced a substantial amount of socio-occupational decline that can be difficult to reverse. The emphasis has therefore shifted to defining psychosis-risk syndromes and evaluating treatments that can prevent transition to psychosis in these ultra-high risk groups. To consider the appropriateness of adding psychosis risk syndrome to our diagnostic nomenclature, the psychotic disorders work group extensively reviewed all available data, consulted a range of experts, and carefully considered the variety of expert and public comments on the topic. It was clear that reliable methods were available to define a syndrome characterized by sub-threshold psychotic symptoms (in severity or duration) and which was associated with a very significant increase in the risk of development of a full-fledged psychotic disorder (schizophreniaspectrum, psychotic mood disorder, and other psychotic disorders) within the next year. At the same time, the majority of individuals with "attenuated psychotic symptoms" had one or more other current psychiatric comorbid conditions (usually mood or anxiety disorders, substance use disorder; Fusar-POLI2012) and exhibited a range of psychiatric outcomes other than conversion to psychosis (significant proportions either fully recover or develop some other psychiatric disorder, with a minority developing a psychotic disorder). Although the reliability of the diagnosis is well established in academic and research settings, it was found to be less so in community and other clinical settings. Furthermore, the nosological relationship of attenuated psychosis syndrome (APS) toschizotypalpersonality disorder and other psychiatric conditions was unclear. Further study will hopefully resolve these questions. The work group decided to recommend the inclusion of attenuated psychosis syndrome as a category in the appendix (Section 3) of DSM-5 as a condition for further study. |
| SCZ Keywords | schizophrenia, schizotypal |