Volume 3 Issue 1
Authors: Marisa Gorovitz; Kevin McMahon; Stephanie Polito; Cheryl Corcoran; Dolores Malaspina; Eugene Ruby
Abstract: While researchers have for decades considered the role of social factors, endocrinology, neural function, hippocampal integrity, and cognition in the development of schizophrenia, there has been a relative paucity of studies considering the participation of the stress cascade in the interplay of these elements. As described in this review, stressful exposures and stress sensitivity may plausibly be argued to play a role in the etiology, neurobiology, and course of schizophrenia and related psychotic disorders. Notably, research conducted over the last decade has made it increasingly clear that childhood traumatic experiences represent a prominent risk factor for the development of psychotic disorders, including schizophrenia. Accumulating evidence suggests that this relationship is mediated by the development of a neuropathological stress response, involving HPA axis dysregulation, aberrant functioning of different neurotransmitter systems, hippocampal damage, and memory deficits. However, it remains difficult to identify exact causal pathways linking early trauma to schizophrenia, including to the individual symptoms associated with the disorder. In addition to the strong association among early trauma, stress sensitization, and positive symptoms in schizophrenia, there is also evidence indicating that the negative and cognitive symptoms are related to these factors. However, the emergence of these symptoms may lie on a distinct and non-interacting pathway in relation to the development of the positive symptoms. The natural increases in stress sensitivity and HPA axis activity during adolescence may act on already maladaptive stress circuitry resulting from early trauma and/or a genetic predisposition to produce full blown stress sensitization and cause epigenetic effects, such as the altered methylation of different genes, that lead to schizophrenia or other psychiatric illnesses.
Keywords: Schizophrenia; Childhood Traumatic Experiences; Childhood Trauma; Early Trauma; Stress Sensitization; Stress Sensitivity; Neurobiology of Schizophrenia; Etiology of Schizophrenia; Epidemiology of Schizophrenia
Authors: C. Thomas Gualtieri
Abstract: The Neuropsych Questionnaire (NPQ) addresses two important clinical issues: how to screen patients from a wide range of neuropsychiatric disorders quickly and efficiently; and how to acquire independent verification of a patient’s complaints. The NPQ is available on the Internet in both adult and pediatric versions, and its adult version consists of 207 simple questions about common symptoms of neuropsychiatric disorders. The NPQ reports give the scores of the patient’s and/or observer’s responses in terms of 20 symptom clusters: inattention, hyperactivity-impulsivity, learning problems, memory, anxiety, panic, agoraphobia, obsessions and compulsions, social anxiety, depression, mood instability, mania, aggression, psychosis, somatization, fatigue, sleep, suicide, pain and substance abuse. In this paper, the factor analysis with a large number of patients are carried out to investigate the factor structure of the NPQ and report the correspondence between the NPQ and other clinical RSs in common use. This analysis generates three distinct factors: cognitive, somatic and manic– and anxiety- depression. The symptoms scales composed of the anxiety-depression factor load equally with those of the mania and somatic factors but not those of the cognitive factor. In summary, the NPQ is a useful tool in neuropsychiatric practice. It also generates interesting data about the nature of symptom self-report and its relationship with specific psychiatric diagnoses.
Keywords: Neuropsych Questionnaire; Symptom Questionnaire; Self-Rating