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Letters to the Editor
February 2007

Distinguishing Vulnerability, Prediction, and Progression in the Preschizophrenic Brain

Arch Gen Psychiatry. 2007;64(2):250-251. doi:10.1001/archpsyc.64.2.250

Velakoulis and colleagues1 are to be congratulated on conducting an impressively large study of medial temporal lobe volumes in patients at different stages of psychosis. They do, however, overinterpret their results. In particular, they say in the “Abstract” that “Medial temporal lobe structural changes are not seen until after the onset of psychotic illness. . . . ”1(p139) This statement and some others in the “Comment” section of the article contradict a much larger body of literature, and even their own previous studies,2,3 and appear to conflate vulnerability to, prediction of, and progression toward psychosis. Further, there are reasons to believe that despite the size of this current study, Velakoulis et al may be presenting some false-negative results.

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