Schultz S K, Andreasen N C
Mental Health Clinical Research Center, Department of Psychiatry, University of Iowa, Iowa City 52242, USA.
Lancet. 1999 Apr 24;353(9162):1425-30. doi: 10.1016/s0140-6736(98)07549-7.
Schizophrenia is among the most severe and debilitating of psychiatric disorders. Diagnosis is currently by criterion-based systems, including positive (eg, hallucinations and delusions) and negative (eg, avolition and alogia) symptoms. The importance of negative symptoms in the course and outcome of the illness is increasingly being studied. Current research seeks to detect causal mechanisms in schizophrenia through studies of neural connectivity and function, as well as models of genetic transmission, such as polygenic models of inheritance in genetic research. Potential genes have been identified that may confer vulnerability to the illness, perhaps in conjunction with environmental factors. Neuroimaging research with magnetic resonance imaging and positron emission tomography has investigated differences in volumes and functional dysregulation in specific neural subregions. Areas studied include the frontal and temporal cortex, the hippocampus, the thalamus, and the cerebellum. Despite these advances, treatment of symptoms and psychosocial and cognitive impairments remains only partially successful for many patients.
精神分裂症是最严重且使人衰弱的精神疾病之一。目前的诊断基于标准系统，包括阳性症状（如幻觉和妄想）和阴性症状（如意志缺乏和言语减少）。阴性症状在疾病进程和转归中的重要性正越来越多地得到研究。当前的研究试图通过对神经连接性和功能的研究以及遗传传递模型（如遗传研究中的多基因遗传模型）来检测精神分裂症的因果机制。已经确定了一些潜在基因，这些基因可能使人易患该疾病，或许还与环境因素有关。利用磁共振成像和正电子发射断层扫描进行的神经影像学研究调查了特定神经亚区域在体积和功能失调方面的差异。研究的区域包括额叶和颞叶皮质、海马体、丘脑和小脑。尽管有这些进展，但对于许多患者而言，症状以及心理社会和认知障碍的治疗仅取得了部分成功。
