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The boundaries of schizophrenia
L J Siever1, O F Kalus, R S Keefe
1Mount Sinai School of Medicine, New York, New York.
The Psychiatric Clinics of North America
|June 1, 1993
Summary
Schizotypal personality disorder may be part of a schizophrenia continuum, with distinct "negative" and "positive" symptom dimensions linked to different brain functions. Understanding these milder disorders offers clues to chronic schizophrenia
Area of Science:
- Psychiatry
- Neuroscience
- Genetics
Background:
- Schizotypal personality disorder (SPD) shows close ties to chronic schizophrenia.
- Evidence suggests SPD may exist on a continuum with schizophrenia-related disorders.
- Defining the boundaries of schizophrenia and related disorders requires further clarification.
Purpose of the Study:
- To explore the relationship between schizotypal personality disorder and chronic schizophrenia.
- To clarify the commonalities and differences within the schizophrenia spectrum.
- To investigate the potential pathophysiological dimensions of schizophrenia-related disorders.
Main Methods:
- Multidimensional approach to schizophrenia-related disorders.
- Analysis of phenomenologic, genetic, psychological, and neurobiological data in SPD patients.
- Examination of neuropsychological, psychophysiologic, neurochemical, and imaging correlates.
Main Results:
- Deficit-like or "negative" symptoms in SPD correlate with altered frontal cortical function and potential structural changes (e.g., increased ventricular size).
- Psychotic-like or "positive" symptoms in SPD appear linked to dopaminergic activity, potentially responsive to neuroleptics.
- Two distinct but interactive pathophysiological dimensions may converge to cause chronic schizophrenia.
Conclusions:
- SPD and related personality disorders may offer insights into the pathophysiology and genetics of chronic schizophrenia.
- These milder, underrecognized disorders are likely more prevalent than severe forms of schizophrenia.
- A multidimensional approach is crucial for understanding the schizophrenia spectrum.