Cerebellar morphology as a predictor of symptom and psychosocial outcome in schizophrenia

Background: In this study, we examined whether brain morphology assessed early in the course of schizophrenia predicted psychosocial or symptomatic outcome. Methods: We acquired magnetic resonance images on 63 subjects with schizophrenia spectrum disorders and manually traced regions of interest, including the cerebrum, temporal lobes, ventricles, and cerebellum. Subjects were then prospectively assessed every 6 months for an average of 7 years. Outcome symptom measures were longitudinal rather than cross-sectional, and included average number of weeks per year spent in a psychotic, negative, or disorganized symptom syndrome, and average number of weeks of inpatient treatment per year. A psychosocial outcome measure summed ratings of impairment in employment, recreation, sexual activity and interpersonal relationships. Results: Negative associations were found between cerebellar volume and three outcome measures: negative and psychotic symptom duration, and psychosocial impairment. Conclusions: These results underscore the potential role of cerebellar abnormalities in the etiology and pathophysiology of schizophrenia. Biol Psychiatry 1999;45: 41-48 (C) 1999 Society of Biological Psychiatry.