Abstract
Recently, psychiatry has become an evidence-based field of medicine. However, there is a lack of reliable predictions of risk of onset, course, and outcome for major psychiatric disorders, e.g. schizophrenia.
Available prediction models in psychiatry are tautological, heuristic, logical, and irrelevant. Logical models of prediction in schizophrenia are based on genetic, neuroimaging (structural and functional), and neuroendocrine studies.
Genetic research searches the causes of illness and pharmacogenetic predictors of treatment response. There are numerous studies of candidate gene encoding COMT polymorphism, or pharmacogenetics of response to clozapine.
Neuroanatomical and functional abnormalities are generally associated with unfavorable course, outcome and treatment failure. Neuroendocrine studies measure directly or indirectly, using challenge tests, functional state of neurotransmitter systems.
Results of d-fenfluramine challenge test investigating relationship between 5-HT system reactivity and response to antipsychotic treatment in young acute schizophrenia patients are presented. Examples of genetic, neuroimaging, and neuroendocrine studies represent models of successful logical prediction in psychiatry based on the solid theoretical background.
Implementation of neuroimaging methods, genetic analyses, and neuroendocrine tests into the clinical practice, may help to individualize diagnostics and treatment of schizophrenia