TY - JOUR TI - Modeling psychological function in patients with schizophrenia with the PANSS: An international multi-center study AU - Fountoulakis, K.N. AU - Dragioti, E. AU - Theofilidis, A.T. AU - Wiklund, T. AU - Atmatzidis, X. AU - Nimatoudis, I. AU - Thys, E. AU - Wampers, M. AU - Hranov, L. AU - Hristova, T. AU - Aptalidis, D. AU - Milev, R. AU - Iftene, F. AU - Spaniel, F. AU - Knytl, P. AU - Furstova, P. AU - From, T. AU - Karlsson, H. AU - Walta, M. AU - Salokangas, R.K.R. AU - Azorin, J.-M. AU - Bouniard, J. AU - Montant, J. AU - Juckel, G. AU - Haussleiter, I.S. AU - Douzenis, A. AU - Michopoulos, I. AU - Ferentinos, P. AU - Smyrnis, N. AU - Mantonakis, L. AU - Nemes, Z. AU - Gonda, X. AU - Vajda, D. AU - Juhasz, A. AU - Shrivastava, A. AU - Waddington, J. AU - Pompili, M. AU - Comparelli, A. AU - Corigliano, V. AU - Rancans, E. AU - Navickas, A. AU - Hilbig, J. AU - Bukelskis, L. AU - Stevovic, L.I. AU - Vodopic, S. AU - Esan, O. AU - Oladele, O. AU - Osunbote, C. AU - Rybakowski, J.K. AU - Wojciak, P. AU - Domowicz, K. AU - Figueira, M.L. AU - Linhares, L. AU - Crawford, J. AU - Panfil, A.-L. AU - Smirnova, D. AU - Izmailova, O. AU - Lecic-Tosevski, D. AU - Temmingh, H. AU - Howells, F. AU - Bobes, J. AU - Garcia-Portilla, M.P. AU - García-Alvarez, L. AU - Erzin, G. AU - Karadaǧ, H. AU - De Sousa, A. AU - Bendre, A. AU - Hoschl, C. AU - Bredicean, C. AU - Papava, I. AU - Vukovic, O. AU - Pejuskovic, B. AU - Russell, V. AU - Athanasiadis, L. AU - Konsta, A. AU - Stein, D. AU - Berk, M. AU - Dean, O. AU - Tandon, R. AU - Kasper, S. AU - De Hert, M. JO - CNS Spectrums PY - 2021 VL - 26 TODO - 3 SP - 290-298 PB - Cambridge University Press SN - 1092-8529, 2165-6509 TODO - 10.1017/S1092852920001091 TODO - 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 TODO - 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. ER -