Disclosures: The authors report no financial disclosures or conflicts of interest.
Development of liability syndromes for schizophrenia: Where did they come from and where are they going?
Article first published online: 17 OCT 2013
© 2013 Wiley Periodicals, Inc.
American Journal of Medical Genetics Part B: Neuropsychiatric Genetics
Special Issue: Identifying the Origins of Mental Illness: A Festschrift in Honor of Ming T. Tsuang
Volume 162, Issue 7, pages 687–697, October 2013
How to Cite
2013. Development of Liability Syndromes for Schizophrenia: Where Did They Come From and Where Are They Going? Am J Med Genet Part B 162B:687–697., .
- Issue published online: 17 OCT 2013
- Article first published online: 17 OCT 2013
- Manuscript Accepted: 21 JUN 2013
- Manuscript Received: 19 FEB 2013
- NIMH. Grant Numbers: MH081928, MH065571
- Commonwealth Research Center of the Massachusetts Department of Mental Health. Grant Number: SCDMH82101008006
- schizophrenia liability;
- negative symptoms
Three decades after Paul Meehl proposed the term “schizotaxia” to describe a conceptual framework for understanding the liability to schizophrenia, Ming Tsuang et al. at Harvard University reformulated the concept as a clinical syndrome with provisional research criteria. The reformulated view relied heavily on more recent data showing that many non-psychotic, un-medicated biological relatives of individuals with schizophrenia showed difficulties in cognitive and other clinical functions that resembled those seen in their ill relatives. The reformulation raised questions about both whether and when liability could be assessed validly in the absence of psychosis, and about the extent to which symptoms of liability are reversible. Both questions bear on the larger issue of early intervention in schizophrenia. This article reviews the efforts of Tsuang et al. to conceptualize and validate schizotaxia as one such syndrome of liability. Towards this end, liability is considered first more generally as an outcome of interactive genetic and environmental factors. Liability is then considered in the context of endophenotypes as a concept that is both broader and is potentially more specific (and predictive) than many DSM or ICD diagnostic symptoms. Liability syndromes are then considered in the context of their proximity to illness, first by reviewing prodromal syndromes (which are more proximal), and then by considering schizotaxia, which, as it is currently formulated, is pre-prodromal and, therefore, less proximal. Finally, challenges to validation and future directions for research are considered. © 2013 Wiley Periodicals, Inc.