A case against subtyping in schizophrenia

Terry E. Goldberg, Daniel R. Weinberger

Research output: Contribution to journalArticle

Abstract

In this paper we consider the generally accepted view that schizophrenia is 'heterogeneous'. We point out that the view derives from prima facie evidence from clinical presentation, studies of course, and factor analysis. However, upon closer examination internal contradictions are apparent, e.g., subtypes change, different groupings of symptoms cooccur in the same individual. Another type of paradigm, depending on careful study of case controls (e.g., monozygotic twins discordant for schizophrenia) and distributions, indicates that abnormalities in neurocognition, regional cerebral blood flow, and regional neuroanatomy may be present in nearly every patient, irrespective of absolute level or diagnostic subtype. These results suggest that a simple model in which patients vary along a severity dimension might parsimoniously explain much of the variance. Thus, while it is possible and even probable that schizophrenia may have many etiologies, phenocopies may represent the expression of a unitary pathogenesis of greater or lesser impact.

Original languageEnglish (US)
Pages (from-to)147-152
Number of pages6
JournalSchizophrenia Research
Volume17
Issue number2
DOIs
StatePublished - Oct 1995
Externally publishedYes

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Keywords

  • (Schizophrenia)
  • Cognition
  • Subtyping
  • Symptom

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

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