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Inconclusive Evidence in Support of the Dopamine Hypothesis of Psychosis: Why Neurobiological Research Must Consider Medication Use, Adjust for Important Confounders, Choose Stringent Comparators, and Use Larger Samples

Hengartner, MP; Moncrieff, J; (2018) Inconclusive Evidence in Support of the Dopamine Hypothesis of Psychosis: Why Neurobiological Research Must Consider Medication Use, Adjust for Important Confounders, Choose Stringent Comparators, and Use Larger Samples. Frontiers in Psychiatry , 9 , Article 174. 10.3389/fpsyt.2018.00174. Green open access

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Abstract

Despite several inconsistencies and methodological biases (1), the dopamine hypothesis (DH) remains a popular topic in schizophrenia research. In its current version III, the DH asserts that environmental stress and substance abuse, in interaction with a genetic susceptibility, lead to dopamine dysregulation, and that increases in striatal presynaptic dopamine concentration causes psychosis (or proneness to psychosis) through a process of aberrant salience to external stimuli (2). Recently, Jauhar et al. (3) examined the putative role of striatal dopamine synthesis capacity in patients with bipolar disorders with current or previous psychotic episode compared to patients with first-episode schizophrenia and healthy controls. Though this study and similar others (for a review, see 2) may show an association between the dopaminergic system and psychosis, these findings cannot provide convincing evidence in support of the DH due to several methodological limitations. In the following we will outline these biases by using Jauhar et al. (3) as a benchmark study. However, the same issues likewise apply to other highly cited original research on the DH (e.g., 4, 5).

Type: Article
Title: Inconclusive Evidence in Support of the Dopamine Hypothesis of Psychosis: Why Neurobiological Research Must Consider Medication Use, Adjust for Important Confounders, Choose Stringent Comparators, and Use Larger Samples
Open access status: An open access version is available from UCL Discovery
DOI: 10.3389/fpsyt.2018.00174
Publisher version: https://doi.org/10.3389/fpsyt.2018.00174
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Keywords: Science & Technology, Life Sciences & Biomedicine, Psychiatry, dopamine hypothesis, schizophrenia, psychosis, bias, confounding, substance abuse, stress, SCHIZOPHRENIA, BRAIN, METAANALYSIS, MECHANISMS, STRESS, ANTIPSYCHOTICS, TOLERABILITY, HALOPERIDOL, EFFICACY, RELEASE
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10049291
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