Contributions of experimental psychiatry to research on the psychosis prodrome.
Contributions of experimental psychiatry to research on the psychosis prodrome.
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DOI：
10.3389/fpsyt.2013.00170
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发表时间：
2013-12-17
影响因子：
4.7
通讯作者：
Daumann, Jorg
中科院分区：
文献类型：
--
作者：
Bodatsch, Mitja;Klosterkotter, Joachim;Daumann, Jorg
近几十年来，精神病研究和治疗的范式转变将注意力转移到疾病的早期，特别是前驱期。尽管在精神病发展的神经基础方面取得了实质性进展，但导致明显疾病的关键生物学机制尚未得到充分理解。直到今天，一个重要的方法来阐明精神病的神经生物学一直是精神病症状的建模由迷幻物质在健康个体。这些模型有机会在受控的实验环境中诱发特定的神经元畸变和相应的精神病症状。在本文中，我们假设实验精神病学在阐明精神病前驱期的生物学机制方面具有独特的机会。精神病风险症状是衰减的，短暂的，往往只回顾性报告。相应的神经元畸变被认为是动态的。因此，不稳定的精神病理学与观察到的神经功能障碍的相关性在很大程度上还不清楚。在精神病建模中，实验设置不仅允许唤起特定的症状，而且允许同时评估精神病理学、神经生理学和神经心理学。在此，将突出示范，特别强调其潜在的贡献，精神病的发展阐明的martamatergic模型。这种精神病模型似乎是通过在健康个体中诱导精神病样症状来模拟前驱症状的候选者。此外，它改变了前注意处理，如失配负性，这是一种电生理成分，最近被确定为精神病发展的潜在预测标志。总之，实验精神病学有可能进一步阐明精神病前驱症状的生物学机制。更好地了解各自的病理生理学可能有助于识别预测标志物和开发预防性治疗方法。
In the recent decades, a paradigmatic change in psychosis research and treatment shifted attention toward the early and particularly the prodromal stages of illness. Despite substantial progress with regard to the neuronal underpinnings of psychosis development, the crucial biological mechanisms leading to manifest illness are yet insufficiently understood. Until today, one significant approach to elucidate the neurobiology of psychosis has been the modeling of psychotic symptoms by psychedelic substances in healthy individuals. These models bear the opportunity to evoke particular neuronal aberrations and the respective psychotic symptoms in a controlled experimental setting. In the present paper, we hypothesize that experimental psychiatry bears unique opportunities in elucidating the biological mechanisms of the prodromal stages of psychosis. Psychosis risk symptoms are attenuated, transient, and often only retrospectively reported. The respective neuronal aberrations are thought being dynamic. The correlation of unstable psychopathology with observed neurofunctional disturbances is thus yet largely unclear. In modeling psychosis, the experimental setting allows not only for evoking particular symptoms, but for the concomitant assessment of psychopathology, neurophysiology, and neuropsychology. Herein, the glutamatergic model will be highlighted exemplarily, with special emphasis on its potential contribution to the elucidation of psychosis development. This model of psychosis appears as candidate for modeling the prodrome by inducing psychotic-like symptoms in healthy individuals. Furthermore, it alters pre-attentive processing like the Mismatch Negativity, an electrophysiological component which has recently been identified as a potential predictive marker of psychosis development. In summary, experimental psychiatry bears the potential to further elucidate the biological mechanisms of the psychosis prodrome. A better understanding of the respective pathophysiology might assist in the identification of predictive markers, and the development of preventive treatments.