2019年10月12日(土) 14:50 〜 16:30 第12会場 (503)

Organizer / Chair: ‌Yen Kuang YANG (Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan), Co-chair: Toshiya MURAI (Department of Psychiatry, Graduate School of Medicine, Kyoto University, Japan), Discussants: ‌Fumitoshi KODAKA (Department of Psychiatry, The Jikei University School of Medicine, Japan), Shinsuke KOIKE (Center for Evolutionary Cognitive Science, The University of Tokyo, Japan)

In light of the advance of clinical neuro-imaging, several new techniques and constructs have been introduced to lift the veil of schizophrenia on varying levels (e.g., brain volumetric changes, resting-state connectivity, deep learning, and endophenotype). However, the results for guiding on improving clinical practice in treating patients with schizophrenia are still uncertain. There are several novelty efforts for this gap will be presented in this proposed symposium. Four proposed talks will be presented in this symposium. Firstly, fMRI data (T1, resting, task-based data) of first episode psychosis (n=140) with deep learning methods will be presented and its application for how to apply/improve clinical practice will be discussed. Secondly, although dopamine hypothesis for schizophrenia had been proposed for many decades, however the role of dopamine in prognosis of schizophrenia is still debated. Some of the studies to explore dopamine level based on drug naïve patients showed higher DA level could be, compared with their controls. However, does higher DA activity mean trait of schizophrenia in the early phase of illness? The meta-analysis showed controversy result. The possible explanation for the DA role in the pathogenesis in schizophrenia will be proposed in the report. Additionally, it was well known that the deficit/negative symptoms were caused by hypodopaminergic activities. Does DA activity of drug naive patients with schizophrenia predict outcome? This second part of symposium will show higher dopaminergic activities in the drug naïve patient will show better prognosis in their 8-year follow-up study. Besides, the correlation of dopamine availability and volumetric changes in drug naïve patient will be presented and their clinical application will be discussed. Thirdly, a leading hypothesis regarding the etiology of schizophrenia emphasizes the pivotal role of dysfunctional self in its various manifest symptoms. In support of the hypothesis, a reliable link between atypical self-representation and psychosis has been documented in empirical studies in patients with schizophrenia, other patients with positive psychotic features, and subclinical individuals with psychotic-like experiences. Yet, it has been largely unknown about the specificity of this link. Atypical self-representation may fuel other psychiatric dysfunctions as well as psychosis. Failing to recognize the heterogeneous outcomes of dysfunctional self-representation hence increases the risk for an over-inclusive framework of psychosis, leading to the low predictive power of the dysfunctional self-representation endophenotype for psychotic disorders. It is crucial to systematically investigate self-representation in studying early phase psychosis. Finally, traumatic experience has been shown to be reliable environmental risk factor for schizophrenia, despite the lack of an account for its precise pathogenic mechanism. The final part of this symposium will focus on the relationship between traumatic experience and volumetric changes in patients with schizophrenia.