Origins and perspectives of schizophrenia research (original) (raw)

New Directions for Symptoms and Diagnosis in Schizophrenia

Schizophrenia - Recent Advances and Patient-Centered Treatment Perspectives [Working Title]

Schizophrenia represents one challenging mental disorder from all the psychotic spectrum, considered to be a major health problem worldwide and because of the characteristic symptoms, the diagnosis is associated with high levels of stigmatization. It is quite common that the first acute symptoms to occur in early adult life and cause severe distress not only to the patient in need but also to their families. The schizophrenia clinical picture is usually misunderstood by the general public and consists of positive symptoms, negative symptoms, disorganized speech or behavior during a specific amount of time. In order to establish an accurate diagnosis, it requires taking into consideration both international classification systems, Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and The International Classification of diseases (ICD-10), adding a fresh perspective to the newest chapter of ICD-11 called “Schizophrenia or other primary psychotic disorders”, alongside with t...

More Than One Century of Schizophrenia

The Journal of Nervous and Mental Disease, 2012

Schizophrenia is a very complex psychiatric disorder of unknown etiology, and there is controversy as to whether its name is even appropriate to describe the associated variety of clinical presentations and symptoms. Currently, the diagnosis is essentially based on clinical criteria. These enable a clinical profile to be recognized as encompassing positive symptoms, negative symptoms, disorganization of thinking and behavior, cognitive impairment, mood abnormalities, motor abnormalities, chronic clinical course, and incomplete remissions. The concept has evolved during the past century, and schizophrenia is currently questioned as a single disease entity. Established diagnostic criteria do not mirror the heterogeneity of the disorder. A strategy to deal with clinical heterogeneity in schizophrenia is, perhaps, the adoption of a classification system based on dimensions and stages. An additional strategy to deal with etiological and pathophysiological heterogeneity is to try to identify biomarkers, namely, on the basis of intermediate phenotypes.

Schneiderian first rank symptoms in schizophrenia: A developmental neuroscience evaluation

International journal of developmental neuroscience : the official journal of the International Society for Developmental Neuroscience, 2016

Self disorders in schizophrenia have been suggested to have distinct neurobiological underpinnings. Using comprehensive neuro-scientific assessments including a neurophysiological, a neurochemical and a neuropsychological marker, this study assesses disordered-"self" in schizophrenia. Twenty schizophrenia patients with first rank symptoms (FRS;FRS + ), 20 patients without FRS(FRS-) and 20 healthy controls (HC) were assessed for psychopathology, especially on specially designed FRS score sheets with a narrow and a broad definition. Resting state electroencephalography was acquired using 256-electrodes; gamma spectral-power was measured in 8 regions of interest. Serum BDNF and self-monitoring were also assessed. Comparative and correlation analysis were conducted in addition to a step-wise discriminant function analysis. FRS+ group with greater positive symptom score and a lower negative symptom score, showed significantly increased gamma spectral power, especially on right ...

Diagnostic concepts and the prevention of schizophrenia

2002

See page 517 for research funding and support and author affiliations. S chizophrenia has long been recognized as a devastating disorder for patients and their families. Although substantial progress has been achieved in both its diagnosis and treatment, and in understanding the disorder's neurobiological substrates, a full understanding of its origins and pathogenic mechanisms remains elusive. One obstacle to better understanding the causes of schizophrenia may be its diagnostic criteria (1). The DSM-IV and other nosologies provide a foundation for clinical diagnosis, but there is little basis for regarding the DSM's operational definition as the "true" construct of schizophrenia.

Schizophrenia: the fundamental questions

Brain Research Reviews, 2000

Identifying the correct phentotype of schizophrenia is perhaps the most important goal of modern research in schizophrenia. This identification is the necessary antecedent of indentifying the pathophysiology and etiology. A working model is proposed, which suggests that the phenotype should be defined on the basis of abnormalities in neural circuits and a fundamental cognitive process. This type of unitary model may be more heuristic than early ones that were based on heterogeneous signs and symptoms. q

Schneiderian first rank symptoms: Reconfirmation of high specificity for schizophrenia

Acta Psychiatrica Scandinavica, 1987

The prevalence of Schneiderian first-rank symptoms (FRS) in 294 consecutive admissions to a research unit was evaluated with reference to their diagnostic distribution (SADWRDC). Thirty-five of 58 patients with schizophrenia had FRS, as compared to nine of 190 patients with major depressive disorder. All patients with two or more FRS received a diagnosis of schizophrenia. In the absence of organic or toxic etiology, the specificity of FRS for schizophrenia was 95% and their predictive value was 90%. These findings indicate that FRS should be regarded as strongly suggestive of schizophrenia in the absence of an organic syndrome.

Toward defining schizophrenia as a more useful clinical concept

Delineating schizophrenia remains elusive despite considerable interest and study for more than a century. During this time, a variety of terms and defi ning features have been ascribed to the construct. The predominant contemporary construct, for which substantial limitations persist, has changed little in the past 30 years. With the approaching arrival of the DSM-V , interest in the nosology of schizophrenia has rebounded. Recent publications have focused principally on the following: integrating dimensional approaches to diagnosis, subtypes of schizophrenia, endophenotypes, and identifying those at early risk as part of a staging process. Some have even suggested replacing the term. Although an etiopathic diagnosis remains out of reach, contemporary research is marching down several distinct paths toward defi ning schizophrenia as a construct of greater clinical utility. *Each dimension may be rated as absent, mild, moderate, or severe for current episode or lifetime course. (Adapted from American Psychiatric Association [52].