The present proposal is for the continuation of an ongoing project which is designed to clarify the time course for the development of structural brain abnormalities previously found to be present in chronic schizophrenia and to determine whether progressive brain morphological deterioration occurs in a subgroup of these patients. One hundred twenty individuals with first episodes of schizophreniform illness consecutively admitted to the Department of Psychiatry, SUNY, Stony Brook affiliated facilities will be asked to submit to a brain MRI examination. Seventy controls will be recruited from the community and screened by structured interviews. Controls are proportionally matched to patients for age, gender, and social class and similarly scanned. All subjects will be followed-up and rescanned two and four years after the original scan. All scans will be evaluated for the presence of ventricular enlargement, frontal, limbic system and temporal cortex abnormalities, and subcortical structural change (i.e., basal ganglia). Statistical analyses will be performed to determine whether any abnormalities detected appear stable or change with time. If progressive change is seen after the onset of illness, it will be examined whether the progression is related to clinical course. In addition, it will be determined whether structural brain differences at the onset are predictors of clinical course and outcome in schizophrenia. Detailed records on this group of patients and controls will be maintained in order to provide a cohort for future more long-term follow-up investigations into the course of schizophrenia.
