ArticleCanadian journal of psychiatry. Revue canadienne de psychiatrie2015
Subtyping Schizophrenia by Treatment Response: Antipsychotic Development and the Central Role of Positive Symptoms.
Article in Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 27 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 5 syntheses or guidelines pooled it, 54 citations in OpenAlex.
- Knowledge domain and trends in treatment-resistant schizophrenia (TRS) research based on CiteSpace bibliometrics analysis.Frontiers in pharmacology · 2024Pooled it
- Predictors of treatment resistant schizophrenia: a systematic review of prospective observational studies.Psychological medicine · 2021Pooled it
- Guidelines for the Pharmacotherapy of Schizophrenia in Adults.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2017Pooled it
- Treatment-Resistant Schizophrenia: Treatment Response and Resistance in Psychosis (TRRIP) Working Group Consensus Guidelines on Diagnosis and Terminology.The American journal of psychiatry · 2017Pooled it
- Is treatment-resistant schizophrenia categorically distinct from treatment-responsive schizophrenia? a systematic review.BMC psychiatry · 2017Pooled it
- Comparing the latent state-trait structure of the PANSS in cariprazine-medicated and placebo-controlled patients with acute schizophrenia.European archives of psychiatry and clinical neuroscience · 2024Trial
- Upregulation of DNA repair-related genes in the prefrontal cortex of patients with schizophrenia with low genetic risk.Schizophrenia (Heidelberg, Germany) · 2026Article
- Lurasidone vs. Other Antipsychotics as Augmentation Strategies for Clozapine in Treatment-resistant Schizophrenia: An Observational Multicenter Prospective Study.Current neuropharmacology · 2026Observational
- Non-invasive brain stimulation augmentation therapy for treatment-resistant schizophrenia: a systematic review and network meta-analysis.EClinicalMedicine · 2025Article
- Predicting antipsychotic responsiveness using a machine learning classifier trained on plasma levels of inflammatory markers in schizophrenia.Translational psychiatry · 2025Article
- Beyond vertebrates:Frontiers in psychiatry · 2025Review
- Social cognition among clinical subtypes of schizophrenia.Schizophrenia research. Cognition · 2024Article
- Non-invasive brain stimulation for treatment-resistant schizophrenia: protocol of a systematic review and network meta-analysis.Systematic reviews · 2024Article
- A systematic review of neuroimaging studies of clozapine-resistant schizophrenia.Schizophrenia (Heidelberg, Germany) · 2023Review
- Dopamine Dynamics and Neurobiology of Non-Response to Antipsychotics, Relevance for Treatment Resistant Schizophrenia: A Systematic Review and Critical Appraisal.Biomedicines · 2023Review
- Differential Treatment Responses in Pakistani Schizophrenia Samples: Correlation with Sociodemographic Parameters, Drug Addiction, Attitude to the Treatment and Antipsychotic Agents.Brain sciences · 2023Article
- Machine Learning Algorithm-Based Prediction Model for the Augmented Use of Clozapine with Electroconvulsive Therapy in Patients with Schizophrenia.Journal of personalized medicine · 2022Article
- Striatal glutamate, subcortical structure and clinical response to first-line treatment in first-episode psychosis patients.Progress in neuro-psychopharmacology & biological psychiatry · 2022Article
- Clozapine resistant schizophrenia: Newer avenues of management.World journal of psychiatry · 2021Review
- Treatment Resistance: A Time-Based Approach for Early Identification in First Episode Psychosis.Journal of personalized medicine · 2021Article
Corrections and comments
- Erratum issuedErratum.2016
Authors and funding
8 authors at 6 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We have recently proposed a model for subtyping schizophrenia based on antipsychotic (AP) treatment response. Evidence suggests that APs, both old and new, are comparable in terms of efficacy; however, one AP, clozapine, is uniquely effective in one subgroup of patients (that is, those with treatment-resistant schizophrenia [TRS]). This permits us to subdivide schizophrenia into 3 specific groups: AP responsive, clozapine responsive, and clozapine resistant. Here, we integrate this model with current criteria related to TRS and ultraresistant schizophrenia, the latter referred to in our model as clozapine resistant. We suggest several modifications to existing criteria, in line with current evidence and practice patterns, particularly emphasizing the need to focus on positive symptoms. While APs can favourably impact numerous dimensions related to schizophrenia, it is their effect on positive symptoms that distinguishes them from other psychotropics. Further, it is positive symptoms that are central to AP and clozapine resistance, and it is these people that place the greatest demands on acute and long-term inpatient resources. In moving AP development forward, we advocate specifically focusing on positive symptoms and capitalizing on the evidence we have of 3 subtypes of psychosis (that is, positive symptoms) based on treatment response, implicating 3 distinguishable forms of underlying pathophysiology. Conversely, pooling these groups risks obfuscating potentially identifiable differences. Such a position does not challenge the importance of dopamine D2 receptor blockade, but rather highlights the need to better isolate those other subgroups that require something more or entirely different.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.