Computed tomography (CT) findings in schizophrenia: speculation on the meaning of it all

CAT scan studies linking schizophrenia to structural pathology of the brain are critically reviewed. CAT findings implicate an irreversible, static process, probably occurring early in development and resulting in a reduction of brain mass. The specificity of the process cannot be assessed from CAT images. Clinical correlations suggest that greater structural change is associated with more clinical neurological signs, suggestive of a pathological continuum rather than a sub-group concept. The CAT images are consistent with recent postmortem evidence of limbic-diencephalic pathology in schizophrenia. A structural deficit hypothesis is proposed.