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Modeling psychological function in patients with schizophrenia with the PANSS: An international multi-center study
journal contribution
posted on 2021-06-01, 00:00 authored by K N Fountoulakis, E Dragioti, A T Theofilidis, T Wiklund, X Atmatzidis, I Nimatoudis, E Thys, M Wampers, L Hranov, T Hristova, D Aptalidis, R Milev, F Iftene, F Spaniel, P Knytl, P Furstova, T From, H Karlsson, M Walta, R K R Salokangas, J M Azorin, J Bouniard, J Montant, G Juckel, I S Haussleiter, A Douzenis, I Michopoulos, P Ferentinos, N Smyrnis, L Mantonakis, Z Nemes, X Gonda, D Vajda, A Juhasz, A Shrivastava, J Waddington, M Pompili, A Comparelli, V Corigliano, E Rancans, A Navickas, J Hilbig, L Bukelskis, L I Stevovic, S Vodopic, O Esan, O Oladele, C Osunbote, J K Rybakowski, P Wojciak, K Domowicz, M L Figueira, L Linhares, J Crawford, A L Panfil, D Smirnova, O Izmailova, D Lecic-Tosevski, H Temmingh, F Howells, J Bobes, M P Garcia-Portilla, L García-Alvarez, G Erzin, H Karadaǧ, A De Sousa, A Bendre, C Hoschl, C Bredicean, I Papava, O Vukovic, B Pejuskovic, V Russell, L Athanasiadis, A Konsta, D Stein, Michael BerkMichael Berk, Olivia DeanOlivia Dean, R Tandon, S Kasper, M De HertAbstractBackgroundThe aim of the current study was to explore the changing interrelationships among clinical variables through the stages of schizophrenia in order to assemble a comprehensive and meaningful disease model.MethodsTwenty-nine centers from 25 countries participated and included 2358 patients aged 37.21 ± 11.87 years with schizophrenia. Multiple linear regression analysis and visual inspection of plots were performed.ResultsThe results suggest that with progression stages, there are changing correlations among Positive and Negative Syndrome Scale factors at each stage and each factor correlates with all the others in that particular stage, in which this factor is dominant. This internal structure further supports the validity of an already proposed four stages model, with positive symptoms dominating the first stage, excitement/hostility the second, depression the third, and neurocognitive decline the last stage.ConclusionsThe current study investigated the mental organization and functioning in patients with schizophrenia in relation to different stages of illness progression. It revealed two distinct “cores” of schizophrenia, the “Positive” and the “Negative,” while neurocognitive decline escalates during the later stages. Future research should focus on the therapeutic implications of such a model. Stopping the progress of the illness could demand to stop the succession of stages. This could be achieved not only by both halting the triggering effect of positive and negative symptoms, but also by stopping the sensitization effect on the neural pathways responsible for the development of hostility, excitement, anxiety, and depression as well as the deleterious effect on neural networks responsible for neurocognition.
History
Journal
CNS SpectrumsVolume
26Issue
3Article number
PII S1092852920001091Pagination
290 - 298Publisher
CAMBRIDGE UNIV PRESSLocation
United StatesPublisher DOI
ISSN
1092-8529eISSN
2165-6509Language
EnglishPublication classification
C1 Refereed article in a scholarly journalUsage metrics
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Categories
Keywords
Science & TechnologyLife Sciences & BiomedicineClinical NeurologyPsychiatryNeurosciences & NeurologySchizophreniamodelstaginglong-term courseoutcomeMONOZYGOTIC TWINS DISCORDANTNEGATIVE SYNDROME SCALEDIMENSIONAL STRUCTUREFOLLOW-UPSYMPTOMSNEUROPROGRESSIONPATHOPHYSIOLOGYPATHOGENESISDYSFUNCTIONPSYCHOSES