@article {17778,
	title = {Modeling psychological function in patients with schizophrenia with the PANSS: an international multi-center study.},
	journal = {CNS Spectr},
	year = {2020},
	month = {2020 Apr 15},
	pages = {1-9},
	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 {\textpm} 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.},
	issn = {1092-8529},
	doi = {10.1017/S1092852920001091},
	url = {https://doi.org/10.1017/S1092852920001091},
	author = {Fountoulakis, Konstantinos N and Dragioti, Elena and Theofilidis, Antonis T and Wiklund, Tobias and Atmatzidis, Xenofon and Nimatoudis, Ioannis and Thys, Erik and Wampers, Martien and Hranov, Luchezar and Hristova, Trayana and Aptalidis, Daniil and Milev, Roumen and Iftene, Felicia and Spaniel, Filip and Knytl, Pavel and Furstova, Petra and From, Tiina and Karlsson, Henry and Walta, Maija and Salokangas, Raimo K R and Azorin, Jean-Michel and Bouniard, Justine and Montant, Julie and Juckel, Georg and Haussleiter, Ida S and Douzenis, Athanasios and Michopoulos, Ioannis and Ferentinos, Panagiotis and Smyrnis, Nikolaos and Mantonakis, Leonidas and Nemes, Zs{\'o}fia and Gonda, Xenia and Vajda, Dora and Juhasz, Anita and Shrivastava, Amresh and Waddington, John and Pompili, Maurizio and Comparelli, Anna and Corigliano, Valentina and Rancans, Elmars and Navickas, Alvydas and Hilbig, Jan and Bukelskis, Laurynas and Stevovic, Lidija I and Vodopic, Sanja and Esan, Oluyomi and Oladele, Oluremi and Osunbote, Christopher and Rybakowski, Janusz Κ and Wojciak, Pawel and Domowicz, Klaudia and Figueira, Maria L and Linhares, Ludgero and Crawford, Joana and Panfil, Anca-Livia and Smirnova, Daria and Izmailova, Olga and Lecic-Tosevski, Dusica and Temmingh, Henk and Howells, Fleur and Bobes, Julio and Garcia-Portilla, Maria P and Garc{\'\i}a-Alvarez, Leticia and Erzin, Gamze and Karada{\u g}, Hasan and De Sousa, Avinash and Bendre, Anuja and Hoschl, Cyril and Bredicean, Cristina and Papava, Ion and Vukovic, Olivera and Pejuskovic, Bojana and Russell, Vincent and Athanasiadis, Loukas and Konsta, Anastasia and Stein, Dan and Berk, Michael and Dean, Olivia and Tandon, Rajiv and Kasper, Siegfried and De Hert, Marc}
}
