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Objectives: Large-scale genetic analysis of common variation in schizophrenia has been a powerful approach to understanding this complex but highly heritable psychotic disorder. To further investigate loci, genes and pathways associated more specifically in the well-characterized Australian Schizophrenia Research Bank cohort, we applied genome-wide single-nucleotide polymorphism analysis in these three annotation categories. Methods: We performed a case–control genome-wide association study in 429 schizophrenia samples and 255 controls. Post-genome-wide association study analyses were then integrated with genomic annotations to explore the enrichment of variation at the gene and pathway level. We also examine candidate single-nucleotide polymorphisms with potential function within expression quantitative trait loci and investigate overall enrichment of variation within tissue-specific functional regulatory domains of the genome. Results: The strongest finding (p = 2.01 × 10−6, odds ratio = 1.82, 95% confidence interval = [1.42, 2.33]) in genome-wide association study was with rs10252923 at 7q21.13, downstream of FZD1 (frizzled class receptor 1). While this did not stand alone after correction, the involvement of FZD1 was supported by gene-based analysis, which exceeded the threshold for genome-wide significance (p = 2.78 × 10−6). Conclusion: The identification of FZD1, as an independent association signal at the gene level, supports the hypothesis that the Wnt signalling pathway is altered in the pathogenesis of schizophrenia and may be an important target for therapeutic development. [ABSTRACT FROM AUTHOR]

Objective: Complex treatment decisions can be suboptimal due to lack of a reliable decision-making model, a need this paper aims to meet.Method: A model for making complex treatment decisions is introduced.Results: The utility of the proposed method is demonstrated by making a complex treatment decision involving evaluation of clozapine treatment in a treatment-resistant patient.Conclusion: The proposed method implemented as a software tool can provide a framework for shared decision-making involving the patient. [ABSTRACT FROM AUTHOR]

Objective: Clinical reasoning in psychiatry may be considered to be more challenging than in other branches of medicine because of its highly subjective nature. The literature on systematic approaches to the teaching of clinical reasoning in psychiatry is lacking, and we propose an approach that may assist educators and learners. Method: A systematic approach with a theoretical underpinning in logical inferences will be proposed as a teaching and learning tool. Conclusion: This paper complements our previous paper on psychiatric case formulation and expands our model of a theoretical framework for diagnostic reasoning and case formulation in psychiatry. Our approach also serves as a tool to assist in integrating the diverse clinical knowledge base in psychiatry. [ABSTRACT FROM AUTHOR]

Objective: Psychiatric formulation is often considered a challenging task, particularly for trainees and students in psychiatry. The process of arriving at a good psychiatric formulation involves identifying major issues of the patient, and developing an explanatory system, which can be derived using known theoretical models in psychiatry. A good explanatory system should provide a high degree of coherence by linking the most relevant data, justification for the proposed management plan, and its feasibility. Unfortunately, the literature on ‘how’ to develop psychiatric formulation is limited, and for the trainees, psychiatric formulation remains a challenging task.Method: Based on the clinical reasoning strategy known as pattern recognition, a methodology for psychiatric case formulation has been proposed. The methodology uses a repository of templates, which are derived from major theoretical models in psychiatry. Developing a formulation involves a process of selecting, prioritising and combining templates according to the elicited set of main issues or psychopathology. The pattern resulting from the combination of different templates provides a degree of uniqueness to the explanatory system.Conclusion: It is expected that this methodology will help trainees and students to develop a broader understanding and skills in psychiatric formulation. [ABSTRACT FROM AUTHOR]

Objective: This article describes the establishment of the Australian Schizophrenia Research Bank (ASRB), which operates to collect, store and distribute linked clinical, cognitive, neuroimaging and genetic data from a large sample of people with schizophrenia and healthy controls. Method: Recruitment sources for the schizophrenia sample include a multi-media national advertising campaign, inpatient and community treatment services and non-government support agencies. Healthy controls have been recruited primarily through multi-media advertisements. All participants undergo an extensive diagnostic and family history assessment, neuropsychological evaluation, and blood sample donation for genetic studies. Selected individuals also complete structural MRI scans. Results: Preliminary analyses of 493 schizophrenia cases and 293 healthy controls are reported. Mean age was 39.54 years (SD = 11.1) for the schizophrenia participants and 37.38 years (SD = 13.12) for healthy controls. Compared to the controls, features of the schizophrenia sample included a higher proportion of males (cases 65.9%; controls 46.8%), fewer living in married or de facto relationships (cases 16.1%; controls 53.6%) and fewer years of education (cases 13.05, SD = 2.84; controls 15.14, SD = 3.13), as well as lower current IQ (cases 102.68, SD = 15.51; controls 118.28, SD = 10.18). These and other sample characteristics are compared to those reported in another large Australian sample (i.e. the Low Prevalence Disorders Study), revealing some differences that reflect the different sampling methods of these two studies. Conclusion: The ASRB is a valuable and accessible schizophrenia research facility for use by approved scientific investigators. As recruitment continues, the approach to sampling for both cases and controls will need to be modified to ensure that the ASRB samples are as broadly representative as possible of all cases of schizophrenia and healthy controls. [ABSTRACT FROM AUTHOR]