The Creation of Clinical and Biological Concept of Schizophrenia: Participation of Chronic Inflammation and Genetic Predisposition in the Formation of Psychopathological Disorders

The aim of the study was to investigate chronic inammation and genetic predisposition processes, involved in the formation of psychopathological dimensions of schizophrenia and schizophrenia spectrum disorders on the catatonia model. Method: the analysis of PubMed/MEDLINE, RSCI and other sources databases on genetics and immunology of catatonia in comparison with the results of our own clinical and biological studies of catatonic disorders as a model of clinical heterogeneity of positive disorders, as well as various mechanisms of their formation. Results: the results obtained demonstrate the involvement of inammatory mechanisms and genetic factors, not associated with the process of inammation, in the formation of psychopathological disorders in schizophrenia. In accordance with the developed clinical and biological model of schizophrenia, non-specic pathophysiological inammatory mechanisms determine the development of both positive and negative disorders by different, albeit related, molecular mechanisms. Identication of various psychopathological types of positive disorders (by the example of catatonic disorders) and their comparison with the activity of inammation allows us to differentiate these disorders. Such a comparison makes it possible to identify disorders, that are mainly determined by genetic factors, at the stages of the disease, associated with a low level of inammation (basic disorders). Positive disorders, mainly determined by inammatory mechanisms, can probably be considered as less specic, i.e. “secondary” ones. Conclusion: within the framework of the developed concept a different ratio of inammatory and genetic mechanisms, that are not associated with the process of inammation, determines the formation of psychopathological disorders and their clinical heterogeneity at various stages of the disease. These disorders represent a broad continuum, at one pole of which are disorders determined predominantly by inammatory mechanisms, and at the other pole by predominantly genetic ones. The activation of inammation and its attenuation may be one of the variants of a repeatedly recurring cycle of the disease, in which the ratio of inammatory and genetic mechanisms changes.

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