Buchanan R W, Carpenter W T
Maryland Psychiatric Research Ctr., Baltimore 21228, USA.
Schizophr Bull. 1997;23(3):367-72. doi: 10.1093/schbul/23.3.367.
Schizophrenia is a brain disease whose pathophysiology has escaped detection despite intensive investigation. The failure to delineate the neuroanatomy of schizophrenia is related in part to both the subtle nature of the neuropathological abnormalities and to the failure to address adequately the pathophysiological heterogeneity of schizophrenia. The symptoms of schizophrenia aggregate into relatively independent symptom complexes, which suggests that there may be a distinct neural substrate for each complex. If this is true, then the neuroanatomy of schizophrenia is better addressed as the separate neuroanatomies of symptom complexes. However, the use of symptom complexes to guide future neuroanatomical investigations raises crucial methodological issues, including the differentiation of primary versus secondary symptoms, trait versus state characteristics, and continuous versus categorical variables. Decisive hypothesis testing requires that these issues be addressed in study design.
精神分裂症是一种脑部疾病，尽管经过深入研究，其病理生理学仍未被发现。未能描绘出精神分裂症的神经解剖结构，部分原因既在于神经病理异常的细微性质，也在于未能充分解决精神分裂症病理生理学的异质性问题。精神分裂症的症状聚合成相对独立的症状复合体，这表明每个复合体可能有独特的神经基质。如果真是这样，那么精神分裂症的神经解剖结构最好作为症状复合体的单独神经解剖结构来研究。然而，使用症状复合体来指导未来的神经解剖学研究引发了关键的方法学问题，包括区分原发性症状与继发性症状、特质与状态特征，以及连续变量与分类变量。决定性的假设检验要求在研究设计中解决这些问题。
