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Using Biomarker Batteries

      The biggest challenge for psychiatry today is the need to reveal and verify the essential pathologies of psychiatric syndromes, including discovering relevant molecular, synaptic, and circuit formulations of biologically based psychiatric diseases. Any demonstrated pathology that reflects the biology of a facet or characterizes a subgroup of a psychiatric syndrome would be an important target. Medical scientists must have asked this same question in the early 1900s when they were grasping for modern medicine handles on illness manifestations such as fever and dropsy (morbid edema). Psychiatric illness constructs today, as were fever and dropsy in the 1900s, are based on clinical constellations of symptoms and illness course. Multiple lines of evidence do not support the assumption that clinical phenomenological disease constructs are congruent with biologically based disease entities. As Dr. Steve Hyman has opined, for psychiatry, “DSM was a poor mirror of nature (Steve Hyman, M.D. et al., personal communication, 2011).” The task of looking for biologically defined disease characteristics of serious mental illness that may lie orthogonal to clinical diagnostic boundaries is a challenging one. One could ask, “If we eschew clinical phenomenology as the gold standard, what brain characteristic(s) might optimally define a homogeneous disease group within the schizophrenia syndrome?”
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      Linked Article

      • Heritability of Subcortical and Limbic Brain Volume and Shape in Multiplex-Multigenerational Families with Schizophrenia
        Biological PsychiatryVol. 77Issue 2
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          Brain abnormalities of subcortical and limbic nuclei are common in patients with schizophrenia, and variation in these structures is considered a putative endophenotype for the disorder. Multiplex-multigenerational families with schizophrenia provide an opportunity to investigate the impact of shared genetic ancestry, but these families have not been previously examined to study structural brain abnormalities. We estimate the heritability of subcortical and hippocampal brain volumes in multiplex-multigenerational families and the heritability of subregions using advanced shape analysis.
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