Table Of ContentDECONSTRUCTING
PSYCHOSIS
Refining the Research Agenda for DSM-V
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DECONSTRUCTING
PSYCHOSIS
Refining the Research Agenda for DSM-V
Edited by
Carol A. Tamminga, M.D.
Paul J. Sirovatka, M.S.
Darrel A. Regier, M.D., M.P.H.
Jim van Os, M.D., Ph.D.
Published by the
American Psychiatric Association
Arlington, Virginia
Note: The authors have worked to ensure that all information in this book is ac-
curate at the time of publication and consistent with general psychiatric and med-
ical standards, and that information concerning drug dosages, schedules, and
routes of administration is accurate at the time of publication and consistent with
standards set by the U.S. Food and Drug Administration and the general medical
community. As medical research and practice continue to advance, however, ther-
apeutic standards may change. Moreover, specific situations may require a specific
therapeutic response not included in this book. For these reasons and because hu-
man and mechanical errors sometimes occur, we recommend that readers follow
the advice of physicians directly involved in their care or the care of a member of
their family.
The findings, opinions, and conclusions of this report do not necessarily represent
the views and opinions of the officers, trustees, or all members of the American
Psychiatric Association. The views expressed are those of the authors of the indi-
vidual chapters.
Copyright © 2010 American Psychiatric Association
ALL RIGHTS RESERVED
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Library of Congress Cataloging-in-Publication Data
Deconstructing psychosis : refining the research agenda for DSM-V / edited by
Carol A. Tamminga ... [et al.].
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-89042-653-1 (alk. paper)
1. Psychoses. 2. Psychoses—Classification. 3. Diagnostic and statistical man-
ual of mental disorders. I. Tamminga, Carol A.
[DNLM: 1. Diagnostic and statistical manual of mental disorders. 2. Psychotic
Disorders—classification—Congresses. 3. Psychotic Disorders—diagnosis—Con-
gresses. WM 200 D296 2010]
RC512.D395 2010
616.89—dc22
2009005568
British Library Cataloguing in Publication Data
A CIP record is available from the British Library.
CONTENTS
CONTRIBUTORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
DISCLOSURE STATEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xi
FOREWORD: Rethinking Psychosis in DSM-V. . . . . . . . . . . . . . . . . . . xv
Darrel A. Regier, M.D., M.P.H.
INTRODUCTION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .xxi
Jim van Os, M.D., Ph.D.
Carol A. Tamminga, M.D.
1
DECONSTRUCTING PSYCHOSIS CONFERENCE FEBRUARY 2006:
The Validity of Schizophrenia and Alternative Approaches to
the Classification of Psychosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
Judith Allardyce, M.D., M.P.H., Ph.D.
Wolfgang Gaebel, M.D.
Jurgen Zielasek, M.D.
Jim van Os, M.D., Ph.D.
2
BIOLOGICAL, LIFE COURSE, AND CROSS-CULTURAL STUDIES
ALL POINT TOWARD THE VALUE OF DIMENSIONAL AND
DEVELOPMENTAL RATINGS IN THE CLASSIFICATION OF PSYCHOSIS . . . 11
Rina Dutta, MRCPsych
Talya Greene, Ph.D.
Jean Addington, Ph.D.
Kwame McKenzie, MRCPsych
Michael Phillips, M.D., M.P.H.
Robin M. Murray, M.D., D.Sc., FRCPsych, FMedSci
3
CURRENT ISSUES IN THE CLASSIFICATION OF PSYCHOTIC
MAJOR DEPRESSION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Jennifer Keller, Ph.D.
Alan F. Schatzberg, M.D.
Mario Maj, M.D., Ph.D.
4
DECONSTRUCTING BIPOLAR DISORDER:
A Critical Review of Its Diagnostic Validity and
a Proposal for DSM-V and ICD-1. . . . . . . . . . . . . . . . . . . . . . . .45
Eduard Vieta, M.D., Ph.D.
Mary L. Phillips, M.D., MRCPsych
5
DSM-V RESEARCH AGENDA:
Substance Abuse/Psychosis Comorbidity . . . . . . . . . . . . . . . . . .59
Bruce J. Rounsaville, M.D.
6
THE GENETIC DECONSTRUCTION OF PSYCHOSIS . . . . . . . . . . .69
Michael J. Owen, Ph.D., FRCPsych, FMedSci
Nick Craddock, Ph.D., FRCPsych
Assen Jablensky, M.D., D.M.S.C., FRCPsych, FRANZCP
7
HOW SHOULD DSM-V CRITERIA FOR SCHIZOPHRENIA
INCLUDE COGNITIVE IMPAIRMENT?. . . . . . . . . . . . . . . . . . . . .83
Richard S.E. Keefe, Ph.D.
Wayne S. Fenton, M.D.
8
SEARCHING FOR UNIQUE ENDOPHENOTYPES FOR SCHIZOPHRENIA
AND BIPOLAR DISORDER WITHIN NEURAL CIRCUITS AND THEIR
MOLECULAR REGULATORY MECHANISMS. . . . . . . . . . . . . . . . . . .99
Francine M. Benes, M.D., Ph.D.
9
DECONSTRUCTING PSYCHOSIS WITH
HUMAN BRAIN IMAGING. . . . . . . . . . . . . . . . . . . . . . . . . . . .109
Raquel E. Gur, M.D., Ph.D.
Matcheri S. Keshavan, M.D.
Stephen M. Lawrie, M.D., FRCPsych
10
IDENTIFYING FUNCTIONAL NEUROIMAGING BIOMARKERS
OF BIPOLAR DISORDER:
Toward DSM-V. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .131
Mary L. Phillips, M.D., MRCPsych
Eduard Vieta, M.D., Ph.D.
11
THE NEUROPHARMACOLOGY OF PSYCHOSIS. . . . . . . . . . . . .153
Carol A. Tamminga, M.D.
John M. Davis, M.D.
INDEX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173
CONTRIBUTORS
Jean Addington, Ph.D.
Professor, Department of Psychiatry, Faculty of Medicine, University of Toronto,
Ontario, Canada
Judith Allardyce, M.D., M.P.H., Ph.D.
Senior Lecturer, Psychiatric Epidemiology, Department of Psychiatry and Neu-
ropsychology, South Limberg Mental Health Research and Teaching Network,
European Graduate School for Neuroscience, Maastricht University, Maastricht,
The Netherlands
Francine M. Benes, M.D., Ph.D.
Director, Program in Structural and Molecular Neuroscience, McLean Hospital;
Milliam P. and Henry B. Test Professor, Program in Neuroscience and Depart-
ment of Psychiatry, Harvard Medical School, Boston, Massachusetts
Nick Craddock, Ph.D., FRCPsych
Professor of Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genom-
ics and Department of Psychological Medicine and Neurology, The School of
Medicine, Cardiff University, Heath Park, Cardiff, United Kingdom
John M. Davis, M.D.
Gilman Professor of Psychiatry, Department of Psychiatry, University of Illinois at
Chicago, Chicago, Illinois
Rina Dutta, MRCPsych
MRC Research Fellow and Honorary Specialist Registrar, Division of Psychologi-
cal Medicine and Psychiatry, Institute of Psychiatry, King’s College London,
United Kingdom
Wayne S. Fenton, M.D.
Director, Division of Adult Translational Research, National Institute of Mental
Health, Bethesda, Maryland
Wolfgang Gaebel, M.D.
Professor of Psychiatry, Department of Psychiatry and Psychotherapy, Heinrich-
Heine-University, Rhineland State Clinics, Düsseldorf, Germany
vii
viii Deconstructing Psychosis
Talya Greene, Ph.D.
Division of Psychological Medicine and Psychiatry, Institute of Psychiatry, King’s
College London, United Kingdom
Raquel E. Gur, M.D., Ph.D.
Director of Neuropsychiatry, Department of Psychiatry, University of Pennsylvania,
Philadelphia, Pennsylvania
Assen Jablensky, M.D., D.M.S.C., FRCPsych, FRANZCP
Professor of Psychiatry, School of Psychiatry and Clinical Neurosciences, The Uni-
versity of Western Australia, Perth, Australia
Richard S.E. Keefe, Ph.D.
Professor of Psychiatry and Behavioral Sciences and Psychology, Department of
Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham,
North Carolina
Jennifer Keller, Ph.D.
Senior Research Scholar, Department of Psychiatry and Behavioral Sciences, Stan-
ford University School of Medicine, Stanford, California
Matcheri S. Keshavan, M.D.
Professor and Vice Chair, Department of Psychiatry, Beth Israel and Deaconess
Medical Center, Harvard University, Boston, Massachusetts
Stephen M. Lawrie, M.D., FRCPsych
Professor of Psychiatry and Neuroimaging, Division of Psychiatry, University of
Edinburgh, Scotland, United Kingdom
Mario Maj, M.D., Ph.D.
Full Professor and Chairman, Department of Psychiatry, University of Naples
SUN, Naples, Italy
Kwame McKenzie, MRCPsych
Senior Scientist, Social Equity and Health Research Section; Deputy Director of
Continuing and Community Care in the Schizophrenia Program; Professor, De-
partment of Psychiatry, University of Toronto, Ontario, Canada
Robin M. Murray, M.D., D.Sc., MFRCPsych, FMedSci
Professor, Division of Psychological Medicine and Psychiatry, Institute of Psychi-
atry, King’s College London, United Kingdom
Contributors ix
Michael J. Owen, Ph.D., FRCPsych, FMedSci
Director and Head, MRC Centre for Neuropsychiatric Genetics and Genomics
and Department of Psychological Medicine and Neurology, The School of Medi-
cine, Cardiff University, Heath Park, Cardiff, United Kingdom
Mary L. Phillips, M.D., MRCPsych
Professor in Psychiatry and Director of Functional Neuroimaging in Emotional
Disorders, Department of Psychiatry, Western Psychiatric Institute and Clinic,
University of Pittsburgh, Pittsburgh, Pennsylvania; Professor of Clinical Affective
Neuroscience and Honorary Consultant Psychiatrist, Department of Psychologi-
cal Medicine, Cardiff University School of Medicine, Cardiff, United Kingdom;
Visiting Professor in Psychiatry, Institute of Psychiatry, King’s College London,
United Kingdom
Michael Phillips, M.D., M.P.H.
Executive Director, Beijing Suicide Research and Prevention Center, Beijing,
China; Professor, Departments of Psychiatry and Epidemiology, Columbia Uni-
versity, New York, New York
Darrel A. Regier, M.D., M.P.H.
Executive Director, American Psychiatric Institute for Research and Education;
Director, Division of Research, American Psychiatric Association, Arlington, Vir-
ginia
Bruce J. Rounsaville, M.D.
Director, VA VISN1 Mental Illness Research Education and Clinical Center; Pro-
fessor of Psychiatry, Yale University School of Medicine, West Haven, Connecticut
Alan F. Schatzberg, M.D.
Kenneth T. Norris, Jr. Professor and Chairman, Department of Psychiatry and Be-
havioral Sciences, Stanford University School of Medicine, Stanford, California
Carol A. Tamminga, M.D.
Professor and Interim Chair, Department of Psychiatry, University of Texas South-
western Medical School, Dallas, Texas
Paul J. Sirovatka, M.S. (1947-2007)
Director, Research Policy Analysis, Division of Research and American Psychiatric
Institute for Research and Education, American Psychiatric Association, Arlington,
Virginia
