In psychiatry there exist, parallel trends of splitting and clumping of disorders. .Former represents dichotomous Kraepelinian trend and latter stands for integrated approach of unitary psychosis .Advancement of biochemical studies and genetics have provided some evidences in favor of unitary psychosis.
Authors made an internet search at various databases websites including pub med, and Blackwell synergy using, early psychosis, prodrom , neuroprotection, apoptosis as key words. It was followed by manual and internet study of authentic psychiatric journals.
Anatomical, functional and neurochemical studies of brain reveal structural changes in early psychosis.
In schizophrenia, pathological process is progressive. Brain volume loss continues even after onset of overt symptoms.
Study of subjects in prodromal phase shows 15-point drop in GAD. Significant proportion also met criterion of anxiety 86% depression 76% low energy 62% and, social with drawl 71%.
Unitary psychosis symbolizes concept of unity in diversity. Neurodevelopmental apoptotic process has its own direction that manifests in form of affective symptoms, anxiety symptoms, obsessive symptoms cognitive deficits, positive psychotic symptoms and ends with negative symptoms. It is assumed that neurodevelopmental process move from lower to higher centers of brain. Neuroprotection during emerging phase of psychotic disorder can delay the onset. Neurochemical studies shows that SSRIs atypical antipsychotic, anticonvulsants, and lithium has antiapototic properties which modulate the progression This suggests that apoptotic process is the thread that connects apparently different disorder is unitary psychosis.
Neurobiological model can account for unitary psychosis.