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Is there really a split in schizophrenia? The genetic evidence
P McGuffin1, A Farmer, I I Gottesman
1Institute of Psychiatry, London.
Summary
Schizophrenia heterogeneity likely stems from varying genetic loading, not distinct subtypes. Current clinical divisions are unlikely to yield further genetic insights into schizophrenia.
Area of Science:
- Psychiatry
- Genetics
- Schizophrenia Research
Background:
- Clinical presentation of schizophrenia is highly variable.
- The underlying cause of this variability (heterogeneity) is unclear.
- Genetic factors are investigated as a potential source of heterogeneity.
Purpose of the Study:
- To review genetic evidence for schizophrenia heterogeneity.
- To assess traditional clinical subtypes and novel classifications.
- To determine if schizophrenia can be genetically subdivided.
Main Methods:
- Review of genetic evidence related to clinical subtypes.
- Analysis of multivariate statistical methods and classifications (e.g., Crow's type I-II).
- Examination of twin series and family study data.
Main Results:
- Attempts to subdivide schizophrenia clinically have not revealed distinct genetic categories.
- Apparent heterogeneity is more likely due to quantitative differences in genetic liability.
- Evidence supporting a broad genetic vs. non-genetic division of schizophrenia is lacking.
Conclusions:
- Purely clinical subdivisions of schizophrenia are unlikely to be genetically informative.
- Future progress in understanding schizophrenia genetics requires endophenotype discovery and molecular marker strategies.