Eliminate schizophrenia.

Eliminate schizophrenia.
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DOI:
10.1016/j.schres.2022.01.004
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发表时间:
2022-04
影响因子:
4.5
通讯作者:
Vinogradov, Sophia
Vinogradov, Sophia
中科院分区:
医学2区
文献类型:
--
作者:
Zick, Jennifer L.;Staglin, Brandon;Vinogradov, Sophia

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“精神分裂症”被用作一个单一的诊断术语,用于一种在病因学、病理生理学、表现和轨迹方面极其异质的疾病。此外,精神病的存在-其标志性特征-可以在具有其他诊断的个体中观察到,并且生物学和计算定义的精神病生物型不同于与DSM诊断相关的生物型,并且产生不同的治疗预测。我们认为,精神分裂症不仅是污名化的标签,它是没有用的诊断术语,疾病的概念,或科学研究的结构。直到我们能够描绘出一系列功能障碍的分子/细胞和/或宏回路水平映射到精神病倾向,并指出最佳的治疗途径,我们建议消除精神分裂症,并取代它作为一个临时解决方案的新命名。类似于医学中其他广泛描述性疾病概念所做的,这些疾病概念由标志性临床特征定义,然后进一步分型(例如,镰状细胞性贫血,缺铁性贫血),我们建议精神病谱疾病(PSI)的特点是他们的时间特征,相关的修改/因果和症状特征,和治疗反应。
“Schizophrenia” is used as a unitary diagnostic term for an illness that is extremely heterogeneous in its etiology, pathophysiology, presentation, and trajectory. Furthermore, the presence of psychosis—its hallmark characteristic—can be observed in individuals with other diagnoses, and biologically- and computationally-defined psychosis biotypes differ from those associated with DSM diagnoses and yield different treatment predictions. We argue that schizophrenia is not only stigmatizing as a label, it is not useful as a diagnostic term, a disease concept, or a construct for scientific research. Until we are able to delineate a range of dysfunctions across molecular/cellular and/or macrocircuit levels that map onto psychosis-proneness and indicate optimal treatment pathways, we propose to eliminate schizophrenia and replace it with a new nomenclature as an interim solution. Similar to what is done with other broad descriptive disease concepts in medicine which are defined by hallmark clinical features and then further subtyped (e.g., sickle cell anemia, iron deficiency anemia), we propose that psychosis spectrum illnesses (PSIs) be characterized by their temporal characteristics, relevant modifying/causal and symptom features, and treatment responsiveness.
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