Meehl suggested that individuals with schizotaxia would develop either schizotypy or schizophrenia, depending on the protection or liability afforded by environmental circumstances, although he later proposed that schizotaxia need not progress into either of these more overt conditions.42 Given current data showing that, in addition to genes, environmental events (eg, obstetric complications, viruses) augment susceptibility to schizophrenia, Faraone ct al43 proposed that we use the term schizotaxia to indicate the

premorbid, neurobiological substrate of schizophrenia. Now, almost 40 years after the idea of schizotaxia was first advanced, a Histone Acetyltransferase inhibitor preponderance Inhibitors,research,lifescience,medical of evidence shows it to be a clinically meaningful condition. In fact, studies of nonschizotypal, nonpsychotic relatives of schizophrenic patients show that schizotaxia is not merely a theoretical construct, but has distinct psychiatric and neurobiological features. These include negative symptoms, neuropsychological impairment, impaired eye-tracking, and structural brain abnormalities.43 Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical Schizotaxia is a broader construct than schizophrenia. Our empirical studies suggest that the basic symptoms of schizotaxia occurs in 20% to 50% of first-degree relatives

of schizophrenic patients.40,44 In comparison, only about 10% of relatives will become psychotic, and less than 10% will develop schizotypal personality disorder.45,46 These figures suggest that schizotaxia does not

lead inevitably to schizotypal personality or schizophrenia, but in most cases is a long-term condition. This leads to the question of what type of etiological model accounts best for a long-term biological vulnerability (schizotaxia) that, under some circumstances, leads to more serious conditions (schizophrenia). Inhibitors,research,lifescience,medical Diagnostic criteria for schizophrenia ignore its etiology and pathophysiology DSM-III (and later versions) explicitly dissociated diagnostic criteria from speculation about Inhibitors,research,lifescience,medical etiology to avoid incorporating theories of etiology that were not subjected to empirical tests. At this point, however, DSM-III’s rejection of theoretical speculation about etiology should not lead us to reject empirical facts about most etiology as being relevant to diagnosis or conceptualization. Moreover, such a view risks a continuing disconnection of treatment from etiology. Since the introduction of antipsychotic medications, pharmacological treatments have focused on alleviating the most acute, florid symptoms of schizophrenia, ie, those related to psychosis. Although several newer antipsychotic medications also alleviate selected negative symptoms and cognitive deficits, treatment remains symptomatic. It is not aimed at correcting specific causes of the disorder, nor is it aimed at preventing its onset. We recognize how counterintuitive it is to think of psychosis as a somewhat nonspecific end state of schizophrenia.

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