@article{3119703,
    title = "Modeling psychological function in patients with schizophrenia with the PANSS: An international multi-center study",
    author = "Fountoulakis, K.N. and Dragioti, E. and Theofilidis, A.T. and Wiklund, T. and Atmatzidis, X. and Nimatoudis, I. and Thys, E. and Wampers, M. and Hranov, L. and Hristova, T. and Aptalidis, D. and Milev, R. and Iftene, F. and Spaniel, F. and Knytl, P. and Furstova, P. and From, T. and Karlsson, H. and Walta, M. and Salokangas, R.K.R. and Azorin, J.-M. and Bouniard, J. and Montant, J. and Juckel, G. and Haussleiter, I.S. and Douzenis, A. and Michopoulos, I. and Ferentinos, P. and Smyrnis, N. and Mantonakis, L. and Nemes, Z. and Gonda, X. and Vajda, D. and Juhasz, A. and Shrivastava, A. and Waddington, J. and Pompili, M. and Comparelli, A. and Corigliano, V. and Rancans, E. and Navickas, A. and Hilbig, J. and Bukelskis, L. and Stevovic, L.I. and Vodopic, S. and Esan, O. and Oladele, O. and Osunbote, C. and Rybakowski, J.K. and Wojciak, P. and Domowicz, K. and Figueira, M.L. and Linhares, L. and Crawford, J. and Panfil, A.-L. and Smirnova, D. and Izmailova, O. and Lecic-Tosevski, D. and Temmingh, H. and Howells, F. and Bobes, J. and Garcia-Portilla, M.P. and García-Alvarez, L. and Erzin, G. and Karadaǧ, H. and De Sousa, A. and Bendre, A. and Hoschl, C. and Bredicean, C. and Papava, I. and Vukovic, O. and Pejuskovic, B. and Russell, V. and Athanasiadis, L. and Konsta, A. and Stein, D. and Berk, M. and Dean, O. and Tandon, R. and Kasper, S. and De Hert, M.",
    journal = "CNS Spectrums",
    year = "2019",
    volume = "26",
    number = "3",
    pages = "290-298",
    publisher = "Cambridge University Press",
    issn = "1092-8529, 2165-6509",
    doi = "10.1017/S1092852920001091",
    keywords = "adolescent;  adult;  aged;  Article;  correlational study;  depression;  disease association;  disease burden;  disease duration;  disease exacerbation;  disorders of higher cerebral function;  excitement;  female;  hostility;  human;  major clinical study;  male;  mental function;  model;  onset age;  Positive and Negative Syndrome Scale;  psychological function;  schizophrenia;  validity;  clinical trial;  middle aged;  multicenter study;  psychology;  schizophrenia;  very elderly, Adolescent;  Adult;  Aged;  Aged, 80 and over;  Disease Progression;  Female;  Humans;  Male;  Middle Aged;  Schizophrenia;  Schizophrenic Psychology",
    abstract = "Background The aim of the current study was to explore the changing interrelationships among clinical variables through the stages of schizophrenia in order to assemble a comprehensive and meaningful disease model. Methods Twenty-nine centers from 25 countries participated and included 2358 patients aged 37.21 ±Â 11.87 years with schizophrenia. Multiple linear regression analysis and visual inspection of plots were performed. Results The results suggest that with progression stages, there are changing correlations among Positive and Negative Syndrome Scale factors at each stage and each factor correlates with all the others in that particular stage, in which this factor is dominant. This internal structure further supports the validity of an already proposed four stages model, with positive symptoms dominating the first stage, excitement/hostility the second, depression the third, and neurocognitive decline the last stage. Conclusions The current study investigated the mental organization and functioning in patients with schizophrenia in relation to different stages of illness progression. It revealed two distinct cores of schizophrenia, the Positive and the Negative, while neurocognitive decline escalates during the later stages. Future research should focus on the therapeutic implications of such a model. Stopping the progress of the illness could demand to stop the succession of stages. This could be achieved not only by both halting the triggering effect of positive and negative symptoms, but also by stopping the sensitization effect on the neural pathways responsible for the development of hostility, excitement, anxiety, and depression as well as the deleterious effect on neural networks responsible for neurocognition. © 2021 Cambridge University Press. All rights reserved."
}