Skip to main content
SpringerLink
Log in

Schizophrenia: Disease Entity, Disease Entities, or Domains of Psychopathology

  • Conference paper
Psychotic Continuum

Abstract

Schizophrenic patients, regardless of diagnostic concept and criteria applied, show a marked variability in age and type of onset, premorbid or early morbid adjustment, signs and symptoms, treatment response, and course of illness. Extensive between-subject variability is also observed in risk factors (e.g., genetic, gestational and birth complications, and season of birth) and associated biological and psychological features. Although individual variability contributes to differences in clinical manifestations, the observed clinical heterogeneity also underscores a conceptual issue of profound importance. Is schizophrenia a single disease, multiple diseases with certain core manifestations im common, or a varying combination of multiple pathophysiological processes, each leading to a different aspect of the syndrome?

Misc

Supported in part by NIMH grant MH40279 and the National Alliance for Research in Schizophrenia and Depression (NARSAD).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Andreasen NC (1982) Negative symptoms in schizophrenia: definition and reliability. Arch Gen Psychiatry 39:784–788

    PubMed  CAS  Google Scholar 

  • Andreasen NC, Olsen S (1982) Negative v positive schizophrenia; definition and validation. Arch Gen Psychiatry 39:789–794

    PubMed  CAS  Google Scholar 

  • Andreasen N, Nasrallah HA, Dunn V et al (1986) Structural abnormalities in the frontal system in schizophrenia: a magnetic resonance imaging study. Arch Gen Psychiatry 43:136–144

    PubMed  CAS  Google Scholar 

  • Andreasen NC, Flaum M, Swayze VW (1990) Positive and negative symptoms in schizophrenia. Arch Gen Psychiatry 47:615–621

    PubMed  CAS  Google Scholar 

  • Andreasen NC, Rezai K, Alliger R et al (1992) Hypofrontality in neuroleptic-naive patients and in patients with chronic schizophrenia. Assessment with xenon 133 single-photon emission computed tomography and the Tower of London. Arch Gen Psychiatry 49:943–958

    PubMed  CAS  Google Scholar 

  • Arndt S, Alliger RJ, Andreasen NC (1991) The distinction of positive and negative symptoms; the failure of a two-dimensional model. Br J Psychiatry 158:317–322

    Article  PubMed  CAS  Google Scholar 

  • Arnold SE, Hyman BT, Van Hoesen GW et al (1991) Some cytoarchitectural abnormalities of the entorhinal cortex in schizophrenia. Arch Gen Psychiatry 48:625–632

    PubMed  CAS  Google Scholar 

  • Barta PE, Pearlson GD, Powers RE et al (1990) Auditory hallucinations and smaller superior temporal gyral volume in schizophrenia. Am J Psychiatry 147:1457–1462

    PubMed  CAS  Google Scholar 

  • Berrios GE (1985) Positive and negative symptoms and Jackson. Arch Gen Psychiatry 42:95–97

    PubMed  CAS  Google Scholar 

  • Bilder RM, Mukherjee S, Rieder RO et al (1985) Symptomatic and neuropsychological components of defect states. Schizophr Bull 11:409–419

    PubMed  CAS  Google Scholar 

  • Bleuler E (1950) Dementia praecox or the group of schizophenias. (J Zinken, translator). International Universities Press, New York

    Google Scholar 

  • Bogerts B, Meertz E, Schonfeldt-Bausch R (1985) Basal ganglia and limbic system pathology in schizophrenia: a morphometric study of brain volume and shrinkage. Arch Gen Psychiatry 42:784–791

    PubMed  CAS  Google Scholar 

  • Bogerts B, Ashtari M, Degreef G et al (1990) Reduced temporal limbic structure volumes on magnetic resonance images in first-episode schizophrenia. Psychiatry Res 35:1–13

    Article  PubMed  CAS  Google Scholar 

  • Breier A, Buchanan RW, Elkashef A et al (1992) Brain morphology and schizophrenia: an MRI study of limbic, prefrontal cortex and caudate structures. Arch Gen Psychiatry 49:921–926

    PubMed  CAS  Google Scholar 

  • Brown KW, White T (1992) Syndromes of chronic schizophrenia and some clinical correlates. Br J Psychiatry 161:317–322

    Article  PubMed  CAS  Google Scholar 

  • Buchanan RW, Carpenter WT (1994) Domains of psychopathology: an approach for the reduction of heterogeneity in schizophrenia. J Nerv Ment Dis (in press)

    Google Scholar 

  • Buchanan RW, Kirkpatrick B, Heinrichs DW et al (1990) Clinical correlates of the deficit syndrome of schizophrenia. Am J Psychiatry 147:290–294

    PubMed  CAS  Google Scholar 

  • Buchanan RW, Breier A, Kirkpatrick B et al (1993) Structural abnormalities in deficit vs non-deficit schizophrenia. Am J Psychiatry 150:59–65

    PubMed  CAS  Google Scholar 

  • Buchsbaum MS, Ingvar DH, Kessler R et al (1982) Cerebral glucography with positron tomography; use in normal subjects and in patients with schizophrenia. Arch Gen Psychiatry 39:251–259

    PubMed  CAS  Google Scholar 

  • Buchsbaum MS, Neuchterlein KH, Haier RJ et al (1990) Glucose metabolic rate in normals and schizophrenics during the Continuous Performance Test assessed by positron emission tomography. Br J Psychiatry 156:216–227

    Article  PubMed  CAS  Google Scholar 

  • Carlsson M, Carlsson A (1990) Interactions between glutamatergic and monoaminergic systems within the basal ganglia: implications for schizophrenia and Parkinson’s disease. In: Swanson G (ed) Trends in neurosciences, reference edn, vol 13. Elsevier, Cambridge, pp 272–276

    Google Scholar 

  • Carpenter WT, Buchanan RW (1989) Domains of psychopathology relevant to the study of etiology and teratment in schizophrenia. In: Schulz SC, Tamminga CA (eds) Schizophrenia: scientific progress. Oxford Press, New York, pp 13–22

    Google Scholar 

  • Carpenter WT, Heinrichs DW, Alphs LD (1988) Deficit and nondeficit forms of schizophrenia: the concept. Am J Psychiatry 145:578–583

    PubMed  Google Scholar 

  • Carpenter WT, Buchanan RW, Kirkpatrick B et al (1994) Strong inference, theory falsification, and the neuroanatomy of schizophrenia. Arch Gen Psychiatry (in press)

    Google Scholar 

  • Cleghorn JM, Garnett ES, Nahmias C et al (1990) Regional brain metabolism during auditory hallucinations in chronic schizophrenia. Br J Psychiatry 157:562–570

    Article  PubMed  CAS  Google Scholar 

  • Cleghorn JM, Franco S, Szechtman B et al (1992) Toward a brain map of auditory hallucinations. Am J Psychiatry 149:1062–1069

    PubMed  CAS  Google Scholar 

  • Crow TJ (1985) The two-syndrome concept: origins and current status. Schizophr Bull 11:471–486

    PubMed  CAS  Google Scholar 

  • Gruzelier J, Seymour K, Wilson L et al (1988) Impairments on neuropsychologic tests of temporohippocampal and frontohippocampal functions and word fluency in remitting schizophrenia and affective disorders. Arch Gen Psychiatry 45:623–629

    PubMed  CAS  Google Scholar 

  • Gur RE, Mozley PD, Resnick SM et al (1991) Relations among clinical scales in schizophrenia. Am J Psychiatry 148:472–478

    PubMed  CAS  Google Scholar 

  • Jorgensen A, Parnas J (1990) The Copenhagen high-risk study; premorbid and clinical dimensions of maternal schizophrenia. J Nerv Ment Dis 178:370–376

    Article  PubMed  CAS  Google Scholar 

  • Kay SR, Sevy S (1990) Pyramidical model of schizophrenia. Schizophr Bull 16:537–544

    PubMed  CAS  Google Scholar 

  • Klimidis S, Stuart GW, Minas IH et al (1993) Positive and negative symptoms in the psychoses. Re-analysis of published SAPS and SANS global ratings. Schizophr Res 8:11–18

    Article  Google Scholar 

  • Kraepelin E (1971) Dementia praecox and paraphrenia. (Translated from the original, 1919, by RM Barclay). Krieger, New York

    Google Scholar 

  • Kulhara P, Kota SK, Joseph S (1986) Positive and negative subtypes of schizophrenia; a study from India. Acta Psychiatr Scand 74:353–359

    Article  PubMed  CAS  Google Scholar 

  • Levin S (1984) Frontal lobe dysfunctions in schizophrenia. II. Impairments of psychological and brain functions. J Psychiatr Res 18:57–72

    Article  PubMed  CAS  Google Scholar 

  • Liddle PF (1987a) The symptoms of chronic schizophrenia; a reexamination of the positive-negative dichotomy. Br J Psychiatry 151:145–151

    Article  PubMed  CAS  Google Scholar 

  • Liddle PF (1987b) Schizophrenic syndromes, cognitive performance and neurological dysfunction. Psychol Med 17:49–57

    Article  PubMed  CAS  Google Scholar 

  • Liddle PF, Barnes TRF (1990) Syndromes of chronic schizophrenia. Br J Psychiatry 157:558–561

    Article  PubMed  CAS  Google Scholar 

  • Liddle PF, Morris DL (1991) Schizophrenic syndromes and frontal lobe performance. Br J Psychiatry 158:340–345

    Article  PubMed  CAS  Google Scholar 

  • Liddle PF, Friston KJ, Frith CD et al (1992) Patterns of cerebral blood flow in schizophrenia. Br J Psychiatry 160:179–186

    Article  PubMed  CAS  Google Scholar 

  • Minas IH, Stuart GW, Klimidis S et al (1992) Positive and negative symptoms in the psychoses: multidimensional scaling of SAPS and SANS items. Schizophr Res 8:143–156

    Article  PubMed  CAS  Google Scholar 

  • Mirsky AF, Anthony BJ, Duncan CC et al (1991) Analysis of the elements of attention: a neuropsychological approach. Neuropsychology Rev 2:109–145

    Article  CAS  Google Scholar 

  • Mortimer AM, Lund CE, McKenna PJ (1990) The positive: negative dichotomy in schizophrenia. Br J Psychiatry 157:41–49

    Article  PubMed  CAS  Google Scholar 

  • Moscarelli M, Maffei C, Cesana BM et al (1987) An international perspective on assessment of negative and positive symptoms in schizophrenia. Am J Psychiatry 144:1595–1598

    PubMed  CAS  Google Scholar 

  • Neuchterlein KH (1991) Vigilance in schizophrenia and related disorders. In: Steinhauer SR, Gruzelier JH, Zubin J (eds) Handbook of schizophrenia, 5. Elsevier, Amsterdam, pp 397–443

    Google Scholar 

  • Peralta V, de Leon J, Cuesta MJ (1992) Are there more than two syndromes in schizophrenia? A critique of the positive-negative dichotomy. Br J Psychiatry 161: 335–343

    Article  PubMed  CAS  Google Scholar 

  • Pfefferbaum A, Zipursky RB, Lim KO et al (1988) Computed tomographic evidence for generalized sulcal and ventricular enlargement in schizophrenia. Arch Gen Psychiatry 45:633–640

    PubMed  CAS  Google Scholar 

  • Posner MI, Peterson SE (1990) The attention system of the human brain. Annu Rev Neurosci 13:255–42

    Article  Google Scholar 

  • Posner MI, Early T, Reiman E et al (1988) Asymmetries in hemispheric control of attention in schizophrenia. Arch Gen Psychiatry 45:814–821

    PubMed  CAS  Google Scholar 

  • Saykin AJ, Gur RC, Gur RE et al (1991) Neuropsychological function in schizophrenia: selective impairment in memory and learning. Arch Gen Psychiatry 48:618–624

    PubMed  CAS  Google Scholar 

  • Shenton ME, Kikinis R, Jolesz FA et al (1992) Abnormalities of the left temporal lobe and thought disorder in schizophrenia. N Engl J Med 327:604–612

    Article  PubMed  CAS  Google Scholar 

  • Stevens JR (1973) Neuroanatomy of schizophrenia. Arch Gen Psychiatry 29:177–189

    PubMed  CAS  Google Scholar 

  • Strauss JS, Carpenter WT, Bartko JJ (1974) The diagnosis and understanding of chizophrenia. III. Speculations on the processes that underlie schizophrenic symptoms and signs. Schizophr Bull 11:61–75

    PubMed  Google Scholar 

  • Strauss ME (1989) Cognitive markers for schizophrenia: an appraisal. In: Schultz SC, Tamminga CA (eds) Schizophrenia: scientific progress. Oxford Press, New York, pp 103–109

    Google Scholar 

  • Suddath RL, Casanova MF, Goldberg TE et al (1989) Temporal lobe pathology in schizophrenia: a quantitative magnetic resonance imaging study. Am J Psychiatry 146:464–472

    PubMed  CAS  Google Scholar 

  • Tamminga CA, Thaker GK, Buchanan RW et al (1992) Limbic system abnormalities identified in schizophrenia using PET/FDG, and neocortical alterations with the deficit syndrome. Arch Gen Psychiatry 49:522–530

    PubMed  CAS  Google Scholar 

  • Thaker G, Kirkpatrick B, Buchanan RW et al (1989) Oculomotor abnormalities and their clinical correlates in schizophrenia. Psychopharmacol Bull 25:491–498

    PubMed  CAS  Google Scholar 

  • Volkow ND, Wolf AP, Van Gelder P et al (1987) Phenomenological correlates of metabolic activity in 18 patients with chronic schizophrenia. Am J Psychiatry 144: 151–158

    PubMed  CAS  Google Scholar 

  • Wagman AMI, Heinrichs DW, Carpenter WT (1987) The deficit and nondeficit forms of schizophrenia: neuropsychological evaluation. Psychiatry Res 22:310–330

    Article  Google Scholar 

  • Weinberger DR (1987) Implications of normal brain development for the pathogenesis of schizophrenia. Arch Gen Psychiatry 44:660–669

    PubMed  CAS  Google Scholar 

  • Wolking A, Sanfilipo M, Wolf AP (1992) Negative symptoms and hypofrontality in chronic schizophrenia. Arch Gen Psychiatry 49:959–965

    Google Scholar 

  • World Health Organization (1974) Report of the International Pilot Study of Schizophrenia, vol 1. WHO Press, Geneva

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD 21226, USA

    B. Kirkpatrick

Authors
  1. W. T. Carpenter Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. W. Buchanan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Kirkpatrick
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Klinik und Poliklinik für Psychiatrie, Martin-Luther-Universität Halle- Wittenberg, 06097, Halle, Germany

    Andreas Marneros

  2. Department of Psychiatry MHCRC, University of Iowa College of Medicine, 2911, JPP, 200 Hawkins Dr, 52242, Iowa City, IA, USA

    Nancy C. Andreasen MD, Ph.D

  3. Department of Psychiatry, Harvard Medical School at Brockton/West VA Medical Roxbury, 940 Belmont Street, 02401, Brockton, MA, USA

    Ming T. Tsuang MD, Ph.D, D.Sc

Rights and permissions

Reprints and permissions

Copyright information

© 1995 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Carpenter, W.T., Buchanan, R.W., Kirkpatrick, B. (1995). Schizophrenia: Disease Entity, Disease Entities, or Domains of Psychopathology. In: Marneros, A., Andreasen, N.C., Tsuang, M.T. (eds) Psychotic Continuum. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79485-8_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-79485-8_11

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-79487-2

  • Online ISBN: 978-3-642-79485-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation