Title:The Gold Standard Diagnosis of Schizophrenia is Counterproductive: Towards Quantitative Research and Diagnostic Algorithmic Rules (RADAR) and their Derived Qualitative Distinct Classes
Volume: 24
Issue: 20
Author(s): Michael Maes*
Affiliation:
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
- Key Laboratory of Psychosomatic
Medicine, Chinese Academy of Medical Sciences, Chengdu, 610072, China
- Department of Psychiatry, Faculty of
Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, the Thai Red Cross Society,
Bangkok, Thailand
- Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria
- Research Institute,
Medical University Plovdiv, Plovdiv, Bulgaria
- Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul,
02447, Korea
Keywords:
Schizophrenia, Diagnosis, Precision psychiatry, Neuroimmune, Inflammation, Oxidative stress.
Abstract:
Recently, we developed Research and Diagnostic Algorithm Rules (RADAR) to assess
the clinical and pathway features of mood disorders.
The aims of this paper are to review a) the methodology for developing continuous RADAR
scores that describe the clinical and pathway features of schizophrenia, and b) a new method to visualize
the clinical status of patients and the pathways implicated in RADAR graphs.
We review how to interpret clinical RADAR scores, which serve as valuable tools for monitoring
the staging of illness, lifetime suicidal behaviors, overall severity of illness, a general cognitive decline
index, and a behavior-cognitive-psychosocial (BCPS) index that represents the “defect”; and
b) pathway RADAR scores which reflect various protective (including the compensatory immune-
inflammatory system) and adverse (including neuro-immune, neuro-oxidative, and neurotoxic
biomarkers) outcome pathways. Using RADAR scores and machine learning, we created new,
qualitatively different types of schizophrenia, such as major neurocognitive psychosis and simple
psychosis. We also made RADAR graphs, which give us a quick way to compare the patient's clinical
condition and pathways to those of healthy controls.
We generated a personalized fingerprint for each patient, encompassing various clinical and pathway
features of the disorder represented through RADAR graphs. The latter is utilized in clinical
practice to assess the clinical condition of patients and identify treatment-required pathways to
mitigate the risk of recurrent episodes, worsening BCPS, and increasing staging. The quantitative
clinical RADAR scores should be used in schizophrenia research as dependent variables and regressed
on the pathway RADAR scores.
