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Background: Neurosciencecan assist clinical understanding and therapy by finding neurobiologicalmarkers for mental illness symptoms. Objectives: To quantify biomarkers forschizophrenia and schizoaffective disorder and relate these to discretesymptoms of psychosis. Methods: Within a case-control design with multipleexclusion criteria to exclude organic causes and confounding variables, 67 DSMIV-R diagnosed and 67 control participants from a defined hospital, clinic andcommunity catchment area were investigated for candidate markers. Participantsunderwent protocol-based diagnostic-checking and symptom rating via BriefPsychiatric Rating Scale and Positive and Negative Syndrome Scale,functional-rating scales, biological sample-collection and sensory-processingassessment. Blood and urine samples were analysed for monoamineneurotransmitters, their metabolites, vitamin cofactors andintermediate-substances related to oxidative stress and metabolism ofmonoamines. Neurocognitive assessment of visual and auditory processing wasconducted at both peripheral and central levels. Biomarkers were defined byReceiver Operating Curve ROC analysis. Spearman’s analysis exploredcorrelations between discrete symptoms and the biomarkers. Results: ReceiverOperating Curve ROC analysis identified twenty-one biomarkers: elevatedurinary dopamine, noradrenaline, adrenaline and hydroxy pyrroline-2-one as amarker of oxidative stress. Other biomarkers were deficits in vitamins D, B6and folate, elevation of serum B12 and free serum copper to zinc ratio, alongwith deficits in dichotic listening, distance vision, visual and auditory speedof processing, visual and auditory working memory and six middle ear acousticreflex parameters. Discrete symptoms such as delusions, hostility, suicidalityand auditory hallucinations were biomarker-defined and symptom biomarkercorrelations assumed an understandable pattern in terms of the catecholaminesand their relationship to biochemistry, brain function and disconnectivity.Conclusions: In the absence of a full diagnosis, biomarker-symptom-signaturesinform psychiatry about the structure of psychosis and provide anunderstandable pattern that points in the direction of a new neurobiologicalsystem of symptom-formation and treatment.


Biomarkers, Schizophrenia, Psychosis, Mental Illness, Symptom-Profiles

Cite this paper

Fryar-Williams, S. and Strobel, J. 2015 Biomarker Symptom Profiles for Schizophrenia and Schizoaffective Psychosis. Open Journal of Psychiatry, 5, 78-112. doi: 10.4236-ojpsych.2015.51011.

Autor: Stephanie Fryar-Williams1,2,3,4, Jörg E. Strobel1



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