Stoyanov Drozdstoy S
St. Ivan Rilski State Hospital for Mental Disorders, Bulgaria.
Folia Med (Plovdiv). 2010 Jan-Mar;52(1):18-25.
In this paper we set forth the major meta-empirical concepts for mental disorders determination. We especially focus on the methodological prerequisites and particular compounds and the endophenotype construct in a case study of bipolar disorders. It is discussed as a mediating level between the genetic causation and the environmental influences in the mental disorder causation. This epigenetic area includes such constructs as cognitive neuropsychological markers, neurotrophic proteins impairment, instability of circadian rhythms (other chronobiological disturbances as well), deregulation of the motivation and reward mechanisms, changes in the GABA metabolism, symptom provocation with "psychotomymetic" agents, etc. Eventually the core ideas of the original validation theory in comparison with the endophenotype concept are shown as milestones of the novel integration of neurobiology and psychiatry. The major issue posed in the endophenotype debate concerns "the independence from the state". According to the formulation of Hassler and Drevets this notion indicates the presentation of the endophenotype regardless of the activity of the disorder, i.e., its presence even in the pre-morbid and remission periods. In the present study we argue that there is another dimension of "state independence" to be assessed. The validation theory in particular defines the entire space-and-time sequence disposition of the endophenotype indicators, e.g. cognitive-psychological and neuroimaging. It is well known that mental states, whether normal or pathological, are very dynamical, just as their neurophysiological correlates are. By this reason it is necessary to explore their relationships simultaneously.
在本文中，我们阐述了用于确定精神障碍的主要元实证概念。我们特别关注双相情感障碍案例研究中的方法学前提、特定成分以及内表型结构。它被视为精神障碍病因中遗传因果关系和环境影响之间的一个中介层面。这个表观遗传学领域包括认知神经心理学标志物、神经营养蛋白损伤、昼夜节律不稳定（以及其他生物钟紊乱）、动机和奖励机制失调、γ-氨基丁酸代谢变化、用“拟精神病药物”引发症状等结构。最终，与内表型概念相比，原始验证理论的核心思想被视为神经生物学与精神病学新整合的里程碑。内表型辩论中提出的主要问题涉及“与状态无关”。根据哈斯勒和德雷韦茨的表述，这个概念表示内表型的呈现与疾病活动无关，即即使在病前和缓解期也存在。在本研究中，我们认为还有另一个“与状态无关”的维度需要评估。特别是验证理论定义了内表型指标的整个时空序列配置，例如认知心理学和神经影像学指标。众所周知，精神状态，无论是正常的还是病理性的，都非常动态，其神经生理学相关因素也是如此。因此，有必要同时探索它们之间的关系。
