Neuroimaging and other neurobiological indices in schizophrenia: relationship to measurement of functional outcome

Background As understanding of the pathobiology of schizophrenia increases, the challenge is to relate such measures to outcome at a functional level. Aims To consider our current understanding of how neurobiological variables relate to functional outcome and might constitute outcome measures in their own right. Method Critical appraisal of recent evidence on structural and functional imaging, neurological evaluation, early neurodevelopmental indices, genomics, proteomics, metabolomics and apoptotic mechanisms in relation to outcome. Results Studies conducted prospectively from the first episode of schizophrenia are generating more reliable findings but currently lack predictive power. Prediction of transition from 'high-risk' status to first episode has proved somewhat more fruitful, but the gain has been modest and circumscribed. Conclusions Our current level of understanding does not yet allow the generation of predictive models on an individual patient basis. Genomic and metabolomic studies hold particular potential for generating clinically meaningful 'biomarkers' but considerable further work is necessary. Declaration of interest None. Funding detailed in Acknowledgements.