"Schizotaxia": Clinical Implications and New Directions for Research

Faraone, Stephen V.; Green, Alan I.; Seidman, Larry J.; Tsuang, Ming T.

doi:10.1093/oxfordjournals.schbul.a006849

Cited by 102 publications

(84 citation statements)

References 147 publications

(163 reference statements)

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“…As in the domains described above, nonpsychotic relatives of schizophrenia patients demonstrate multiple deficits in cognition that are similar to those seen in schizophrenia sufferers (2,29,(48)(49)(50). Individuals with SPD, for example, show deficits in nonverbal learning, and especially in verbal learning (51), in working memory (52), and in several executive functions, including concept formation, abstraction, and mental flexibility (53).…”

Section: Neuropsychological Deficitsmentioning

confidence: 87%

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Understanding Predisposition to Schizophrenia: Toward Intervention and Prevention

2002

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Objective: Early intervention to prevent schizophrenia is one of the most important goals of schizophrenia research. However, the field is not yet ready to initiate trials to prevent prodromal or psychotic symptoms in people who are at risk for developing the disorder. In this paper, we consider some of the major obstacles that must be studied before prevention strategies become feasible. Method and Results:One of the most important hurdles is the identification of a syndrome or set of traits that reflects a predisposition to schizophrenia and that might provide potential targets for intervention. In a recent reformulation of Paul Meehl's concept of schizotaxia, we integrate research findings obtained over the last 4 decades to propose a syndrome with meaningful clinical manifestations. We review the conceptualization of this syndrome and consider its multidimensional clinical expression. We then describe preliminary research diagnostic criteria for use in adult, nonpsychotic, first-degree relatives of patients diagnosed with schizophrenia, based on negative symptoms and neuropsychological deficits. We follow this with evidence supporting the validity of the proposed syndrome, which mainly includes social dysfunction and response to a low dosage of one of the newer antipsychotic medications. Conclusions:Continued progress toward the eventual initiation of prevention strategies for schizophrenia will include sustained efforts to validate the traits reflecting a predisposition to develop the disorder (for example, schizotaxia), follow-up studies to confirm initial findings, and the identification of potentially useful preventive interventions. (Can J Psychiatry 2002;47:518-526) See page 524 for research funding and support and page 525 for author affiliations.Clinical Implications · The predisposition to develop schizophrenia in nonprodromal, nonpsychotic adult relatives of patients with schizophrenia may be expressed as a meaningful, diagnosable, clinical syndrome or set of traits, called schizotaxia. · In adults, at least some schizotaxia symptoms may be attenuated with interventions. · Interventions that attenuate schizotaxia symptoms in adults may eventually be useful in strategies aimed at preventing schizophrenia.Limitations · Double-blind intervention studies of schizotaxia are needed. · Longitudinal neuroimaging data are needed for children at high risk for developing schizophrenia. · Molecular-genetic studies of schizotaxia are needed to extend and validate the syndrome.

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Section: Neuropsychological Deficitsmentioning

confidence: 87%

“…While some of these deficits may be present in other schizophrenia-related disorders such as SPD, they also exist independently (see [2] for further discussion of similarities and differences between SPD and schizotaxia).…”

Section: Psychosocial Functioningmentioning

confidence: 99%

Understanding Predisposition to Schizophrenia: Toward Intervention and Prevention

2002

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“…In this broad context, we reformulated the term schizotaxia in the 1990s to integrate newer data [59]. Our conception of schizotaxia was consistent with Meehl's view of it as the underlying liability among people predisposed to schizophrenia, though aspects of his view were modified.…”

Section: Development and Validationmentioning

confidence: 73%

“…In contrast, Meehl's conception of the most direct consequence of schizotaxia -schizotypy -was considered observable, and that concept did enter the psychiatric nosology in the modified form of 'schizotypal personality disorder'. By the 1990s, however, a growing body of literature showed that a subset of non-psychotic relatives of people with schizophrenia showed a broad range of measurable abnormalities in brain structure and function, neurophysiological aspects of information processing such as eye tracking and various sensory gating paradigms, neuropsychological function, and social functioning, among others [7,8,17,59]. These findings supported the view that the notion of liability might be amenable to operational definitions, whereas it had not been previously.…”

Section: Foundations Of the Conceptmentioning

confidence: 99%

Recent developments in neuropsychological endophenotypes for schizophrenia: Development of the MATRICS battery, liability syndromes and the near future

Stone

Hsi

2011

Chin. Sci. Bull.

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Cognitive deficits are now recognized widely as core features of schizophrenia, and as major contributors to the clinical outcome of the disorder. They are also studied widely as 'endophenotypes', reflecting a growing consensus that schizophrenia is a broader, more multidimensional illness than the diagnostic criteria required for its formal diagnosis. This evolving view of cognition underlies its utilization in recent initiatives for intervention and assessment in schizophrenia. Two of these initiatives are reviewed in this paper. The first focuses on the development and validation of the MATRICS Cognitive Consensus Battery, a standardized battery of neuropsychological tests developed to assess the effectiveness of cognitive enhancing treatments in schizophrenia. A part of this effort includes the identification of performance-based, 'co-primary' measures of functional capacity that are related to cognition, and that are likely to show improvement at least partly as a function of improved cognition. The second initiative involves efforts to utilize neuropsychological deficits in the identification, validation and remediation of a liability syndrome for schizophrenia ('schizotaxia'). The discussion of this effort focuses on the development of a syndrome that is both measurable and meaningful clinically, and that may provide useful intervention targets. The utilization of cognition in both of these initiatives underscores its functional importance in the clinical outcome of schizophrenia. Moreover, it helps to illuminate indicators of liability for schizophrenia that might be amenable to remediation. schizophrenia, schizotaxia, cognition, liability syndrome, MATRICS, neuropsychology Citation:Stone W S, Hsi X. Recent developments in neuropsychological endophenotypes for schizophrenia: Development of the MATRICS battery, liability syndromes and the near future.

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“…Consequently, Meehl [16] proposed the concept of schizotaxia, as a relatively common, clinically dormant genetic liability, expressed neurobiologically as deficits in neuronal integrity, which sometimes develop into schizophrenia or schizotypy. Faraone et al [17] and Tsuang et al [18], among others, conceptualized schizotaxia as a clinical syndrome mainly characterized by subthreshold negative symptoms and cognitive impairment, which are present in about 20–50% of relatives of schizophrenia subjects.…”

Section: Introductionmentioning

confidence: 99%

Cognitive Impairment and Formal Thought Disorders in Parents of Early-Onset Schizophrenia Patients

Remberk

Namysłowska²,

Rybakowski³

2012

Neuropsychobiology

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Background: Both cognitive impairment and formal thought disorder (communication disturbances) found in patients with schizophrenia are also commonly observed in their relatives. Recently, the role of such deficits as putative endophenotypes of schizophrenia has been proposed. However, in a majority of studies, the families of adult patients were assessed whereas the relatives of early-onset psychotic subjects were rarely studied. The aim of our study was to evaluate the presence of cognitive impairment and formal thought disorders in parents of adolescents with a diagnosis of schizophrenia spectrum disorder (SSD) and in matched healthy controls. Method: Thirty-eight parents of 29 SSD adolescents and 38 healthy controls were assessed with a battery of neurocognitive tests and the Thought, Language and Communication Scale. Results: Parents of schizophrenia patients showed an increased tendency for perseverative thinking when compared to matched healthy controls. No statistically significant differences in cognitive functioning were observed between the groups. Conclusion: These results may suggest the need for further exploration of communication disturbances as a potential endophenotypic marker of early-onset schizophrenia.

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"Schizotaxia": Clinical Implications and New Directions for Research

Cited by 102 publications

References 147 publications

Understanding Predisposition to Schizophrenia: Toward Intervention and Prevention

Understanding Predisposition to Schizophrenia: Toward Intervention and Prevention

Recent developments in neuropsychological endophenotypes for schizophrenia: Development of the MATRICS battery, liability syndromes and the near future

Cognitive Impairment and Formal Thought Disorders in Parents of Early-Onset Schizophrenia Patients

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