PHENOMENOLOGY & CLASSIFICATION OF SCHIZOPHRENIA

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。这项申请是竞争更新的要求，也是我们对精神分裂症诊断和现象学研究的要求。这项工作旨在从潜在机制的角度理解精神分裂症的现象学，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终生病程较长，对信息队列的纵向研究是了解其机制和确定其表型的最有力的策略之一。这个项目试图通过检验两个不同的相互竞争的模型在大样本首发和新发患者中的预测有效性来完善精神分裂症表型的定义，这些患者在多个时间点被纵向跟踪。一种方法是使用三种症状群(精神病性、组织混乱和阴性症状)来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单一精神分裂症模型，在系统水平上由基本认知缺陷(“认知障碍”)定义，在神经水平上由皮质-小脑-丘脑-小脑回路异常(CCTCC)定义。这两个模型的预测有效性将使用来自长期病程评估的四个验证器进行比较：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.