PHENOMENOLOGY & CLASSIFICATION OF SCHIZOPHRENIA

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。这一申请是对精神分裂症诊断和现象学研究竞争性更新的要求。这项工作旨在了解精神分裂症的现象学及其潜在机制，完善我们对其表型的定义，并描述疾病的终身轨迹及其长期结果。由于这种疾病的特点是一个漫长的生命历程，信息队列的纵向研究是了解其机制和定义其表型的最有力的策略之一。该项目旨在通过在多个时间点纵向随访的首发和近期发病患者的大样本中检查两种不同竞争模型的预测有效性，来完善精神分裂症表型的定义。一种方法是使用三种症状群（精神病、紊乱和阴性症状）定义表型的三维模型，目前被广泛接受和研究。第二种方法提出了一种新的精神分裂症统一模型，该模型在系统水平上由基本认知缺陷（“认知障碍”）定义，在神经水平上由皮层-小脑-丘脑-小脑回路（CCTCC）异常定义。这两种模型的预测有效性将通过四个验证器进行比较，这些验证器来自于对长期病程的评估：临床结果、社会心理结果、认知和脑形态。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This application is a request for competitive renewal or our research on the diagnosis and phenomenology of schizophrenia. The work aims to understand the phenomenology of schizophrenia in terms of its underlying mechanisms, refine our definition of its phenotype, and describe the lifelong trajectory of the illness and its long-term outcome. Since the disorder is characterized by a prolonged lifetime course, longitudinal study of informative cohorts is one of the most powerful strategies for understanding its mechanisms and defining its phenotype. This project seeks to refine the definition of the phenotype of schizophrenia by examining the predictive validity of two different competing models in a large sample of first episode and recent onset patients who are followed longitudinally at multiple time points. One approach, a tridimensional model that defines the phenotype using three symptom clusters (psychoticism, disorganization, and negative symptoms) is currently widely accepted an d studied. The second approach proposes a new unitary model of schizophrenia as defined at the systems level by a fundamental cognitive deficit ("cognitive dysmetria") and at the neural level by an abnormality in cortical-cerebellar-thalamic-cerebellar circuitry (CCTCC). The predictive validity of these two models will be compared using four validators derived from the evaluation of long-term course: clinical outcome psychosocial outcome, cognition, and brain morphology.