Abdullah Hussain Muhammad, Azeb Shahul Hameed, Hwang Michael Y, Ferrando Stephen
Department of Psychiatry and Behavioral Health, Behavioral Health Center, Westchester Medical Center, Valhalla, New York (Abdullah, Hwang, Ferrando); Department of Psychiatry, Yale University, New Haven, Connecticut (Azeb Shahul); Department of Psychiatry and Behavioral Health, Health Alliance Hospital, Kingston, New York (Hwang).
Focus (Am Psychiatr Publ). 2020 Oct;18(4):386-390. doi: 10.1176/appi.focus.20200026. Epub 2020 Nov 5.
Schizophrenia is a complex psychiatric disorder that affects cognitive, perceptual, and emotional functioning. The currently available evidence suggests heterogenous intertwining of biological and psychosocial etio-pathogeneses. Clinical and research interests in the comorbidity issues of schizophrenia were borne out of the real-world clinical challenges that patients often present with multiple coexisting psychopathologies as well as comorbid medical conditions. The recent shift toward a symptom dimensional-based perspective, the NIMH Research Domain Criteria (RDoC) initiative to examine biopsychosocial pathogeneses in mental illness, and the FDA's emphasis on real world-based clinical trial criterion all have promoted a shift in clinical research that has facilitated understanding and treatment of comorbidity in schizophrenia. This emerging conceptual shift as well as pharmacological developments that address the multidimensional pathogeneses in schizophrenia may pave the way for a better understanding and treatment.
精神分裂症是一种复杂的精神障碍，会影响认知、感知和情感功能。目前可得的证据表明，生物和心理社会病因病理存在异质性交织。对精神分裂症共病问题的临床和研究兴趣源于现实世界中的临床挑战，即患者常常同时存在多种精神病理学问题以及共病的躯体疾病。最近向基于症状维度的视角转变、美国国立精神卫生研究所（NIMH）的研究领域标准（RDoC）倡议（旨在研究精神疾病的生物心理社会病因病理）以及美国食品药品监督管理局（FDA）对基于现实世界的临床试验标准的强调，都推动了临床研究的转变，有助于对精神分裂症共病的理解和治疗。这种新出现的概念转变以及针对精神分裂症多维病因病理的药理学发展，可能为更好的理解和治疗铺平道路。
