Neuroanatomical abnormalities have been reported along a continuum from at-risk stages, including high schizotypy, to early and chronic psychosis. However, a comprehensive neuroanatomical mapping of schizotypy remains to be established. The authors conducted the first large-scale meta-analyses of cortical and subcortical morphometric patterns of schizotypy in healthy individuals, and compared these patterns with neuroanatomical abnormalities observed in major psychiatric disorders. The sample comprised 3004 unmedicated healthy individuals (12–68 years, 46.5% male) from 29 cohorts of the worldwide ENIGMA Schizotypy working group. Cortical and subcortical effect size maps with schizotypy scores were generated using standardized methods. Pattern similarities were assessed between the schizotypy-related cortical and subcortical maps and effect size maps from comparisons of schizophrenia (SZ), bipolar disorder (BD) and major depression (MDD) patients with controls. Thicker right medial orbitofrontal/ventromedial prefrontal cortex (mOFC/vmPFC) was associated with higher schizotypy scores (r = 0.067, pFDR = 0.02). The cortical thickness profile in schizotypy was positively correlated with cortical abnormalities in SZ (r = 0.285, pspin = 0.024), but not BD (r = 0.166, pspin = 0.205) or MDD (r = −0.274, pspin = 0.073). The schizotypy-related subcortical volume pattern was negatively correlated with subcortical abnormalities in SZ (rho = −0.690, pspin = 0.006), BD (rho = −0.672, pspin = 0.009), and MDD (rho = −0.692, pspin = 0.004). Comprehensive mapping of schizotypy-related brain morphometry in the general population revealed a significant relationship between higher schizotypy and thicker mOFC/vmPFC, in the absence of confounding effects due to antipsychotic medication or disease chronicity. The cortical pattern similarity between schizotypy and schizophrenia yields new insights into a dimensional neurobiological continuity across the extended psychosis phenotype.

There was clinical heterogeneity of the «verschroben» type defect: the differentiation of primary defect syndrome and the «second life» defect was confirmed. This typological classification is based not only on the differences in psychopathological symptoms and impaired social functioning but on the trajectory of the development of deficit syndromes related with the features of the course of endogenous disease. The typology would be useful for future studies of deficit changes in view of clinical prognosis, social context of schizophrenia spectrum disorders with negative «verschroben» type changes.

Neuroanatomical abnormalities have been reported along a continuum from at-risk stages, including high schizotypy, to early and chronic psychosis. However, a comprehensive neuroanatomical mapping of schizotypy remains to be established. The authors conducted the first large-scale meta-analyses of cortical and subcortical morphometric patterns of schizotypy in healthy individuals, and compared these patterns with neuroanatomical abnormalities observed in major psychiatric disorders. The sample comprised 3,004 unmedicated healthy individuals (12-68 years, 46.5% male) from 29 cohorts of the worldwide ENIGMA Schizotypy working group. Cortical and subcortical effect size maps with schizotypy scores were generated using standardized methods. Pattern similarities were assessed between the schizotypy-related cortical and subcortical maps and effect size maps from comparisons of schizophrenia (SZ), bipolar disorder (BD) and major depression (MDD) patients with controls. Thicker right medial orbitofrontal/ventromedial prefrontal cortex (mOFC/vmPFC) was associated with higher schizotypy scores (r=.07, pFDR=.02). The cortical thickness profile in schizotypy was positively correlated with cortical abnormalities in SZ (r=.33, pspin=.01), but not BD (r=.19, pspin=.16) or MDD (r=-.22, pspin=.10). The schizotypy-related subcortical volume pattern was negatively correlated with subcortical abnormalities in SZ (rho=-.65, pspin=.01), BD (rho=-.63, pspin=.01), and MDD (rho=-.69, pspin=.004). Comprehensive mapping of schizotypy-related brain morphometry in the general population revealed a significant relationship between higher schizotypy and thicker mOFC/vmPFC, in the absence of confounding effects due to antipsychotic medication or disease chronicity. The cortical pattern similarity between schizotypy and schizophrenia yields new insights into a dimensional neurobiological continuity across the extended psychosis phenotype.

The relevance of this study is the high prevalence and clinical heterogeneity of deficit states in chronic schizophrenia and schizophrenia spectrum disorders. The study aimed at analyzing negative symptoms in schizophrenia and schizophrenia spectrum disorders from historical and modern perspectives. An analysis of available literature, along with own observations, has been performed. It was found that negative symptoms comprise 3 clinical types: 1) 'pseudopsychopathic' type (overlapping personality dimensions and premorbid/initial negative symptoms), 2) pseudoorganic/asthenic/pseudobradiphrenic type (pseudoorganic states), developing at different stages of schizophrenia), 3) 'new'-life pseudopsychopathic type (not associated with premorbid personality traits), developing at late stages in schizophrenia. The trajectory heterogeneity of negative symptoms in their relation to positive symptoms has been defined: simultaneous-continuous course (synchronous course of positive and negative symptoms), polar course (alternative development of predominantly positive or negative symptoms), simultaneous-phasic course (pseudopsychopathic negative symptoms, attracting depressive symptoms, or depression that exacerbates latent deficit). The authors discuss some aspects of psychopharmacological treatment of negative symptoms. Negative symptoms in schizophrenia and schizophrenia spectrum disorders differ clinically, have heterogeneous trajectory course, and require differentiated approach with regard to psychopathological qualification, prognosis and treatment.