PHENOMENOLOGY & CLASSIFICATION OF SCHIZOPHRENIA

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。本申请是对我们关于精神分裂症诊断和现象学研究的竞争性更新请求。这项工作的目的是了解精神分裂症的现象学在其潜在的机制，完善我们的定义，其表型，并描述疾病的终身轨迹及其长期结果。由于该疾病的特点是一个长期的生命过程中，纵向研究的信息队列是最有力的战略之一，了解其机制，并确定其表型。该项目旨在通过在多个时间点纵向随访的大样本首次发作和近期发作患者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，一个三维模型，定义的表型使用三个症状集群（精神病，混乱，和阴性症状）目前被广泛接受和研究。第二种方法提出了一种新的统一的精神分裂症模型，定义在系统水平上的基本认知缺陷（“认知测不准”）和在神经水平上的异常皮质-小脑-丘脑-小脑电路（CCTCC）。这两种模型的预测有效性将使用四个验证器进行比较，这些验证器来自长期过程的评估：临床结果、心理社会结果、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.