Tsuang M T, Stone W S, Faraone S V
Harvard Medical School Department of Psychiatry at the Massachusetts Mental Health Center; Brockton West Roxbury Veterans Affairs Medical Center; Harvard Institute of Psychiatric Epidemiology and Genetics, Boston, Mass, USA; Department of Epidemiology, Harvard School of Public Health, Boston, Mass, USA.
Dialogues Clin Neurosci. 2000 Dec;2(4):381-91. doi: 10.31887/DCNS.2000.2.4/mtsuang.
A substantial part of the contribution of genetic studies to the treatment of schizophrenia involves its emphasis on reliable and valid diagnoses. One consequence of this focus is the recognition that schizophrenic illness is broader than the diagnostic entity of schizophrenia itself, and instead consists of a "spectrum" of related disorders. Because some of the symptoms in these disorders differ from each other, they provide an opportunity to determine which ones reflect a common etiology. To the extent that such symptoms are identifiable, they may provide a foundation for treatment and even prevention strategies. In this paper, we focus on a clinical condition - "schizotaxia" - that may reflect the liability for schizophrenia. To characterize the nature and extent of this proposed syndrome, we will review results from family studies in our laboratory, and consider conceptual foundations and criteria for assessment. A more general consideration of treatment strategies for schizophrenia spectrum disorders follows, along with suggestions for future research. Our initial attempts to treat and validate schizotaxia are encouraging, and raise the possibility that early treatment might eventually prevent or attenuate the development of other, more severe disorders in the schizophrenia spectrum, including schizophrenia itself.
基因研究对精神分裂症治疗的一大重要贡献在于其对可靠且有效的诊断的强调。这种关注的一个结果是认识到精神分裂症性疾病比精神分裂症本身的诊断实体更为宽泛,实际上它由一系列相关障碍组成。由于这些障碍中的一些症状彼此不同,它们为确定哪些症状反映了共同病因提供了机会。只要能识别出这些症状,就可能为治疗甚至预防策略奠定基础。在本文中,我们聚焦于一种临床状况——“精神分裂症易患性”——它可能反映了患精神分裂症的倾向。为了描述这种拟议综合征的性质和程度,我们将回顾我们实验室家族研究的结果,并考虑其概念基础和评估标准。随后将更全面地探讨精神分裂症谱系障碍的治疗策略,并对未来研究提出建议。我们最初治疗和验证精神分裂症易患性的尝试令人鼓舞,并提出了早期治疗最终可能预防或减轻精神分裂症谱系中其他更严重障碍(包括精神分裂症本身)发展的可能性。