Thomas Wolfers PhD Donders Center for Cognitive Neuroimaging Kapittelweg 29 6525EN Nijmegen  The Netherlands

Significant Variability in Brain Scans of Patients With Schizophrenia and Bipolar Disorder Interview with:

Thomas Wolfers PhD Donders Center for Cognitive Neuroimaging Kapittelweg 29 6525EN Nijmegen  The Netherlands

Dr. Wolfers

Thomas Wolfers PhD
Donders Center for Cognitive Neuroimaging
Kapittelweg 29
6525EN Nijmegen
The Netherlands What is the background for this study? What are the main findings?

Response: Schizophrenia and bipolar disorder are severe and complex mental disorders. Currently, the most common approach in characterizing disorders biologically is by comparing patient groups with groups of healthy individuals.

We employed a fundamentally different approach and investigated how much the brains of individual patients diagnosed with schizophrenia and bipolar disorder differ from one another. For this purpose, we selected brain scans from healthy individuals to model a norm reflecting the healthy range, subsequently we compared the brain scans of patients with schizophrenia and bipolar disorder to this norm on the level of the individual.

The main outcome was that individuals with schizophrenia and bipolar disorder differ substantially from one another, thus, considering only the ‘average patient’ has little to say about what might be occurring in the brain of an individual patient. What should readers take away from your report?

Response: We can see substantial variation in the brains of different individuals with schizophrenia, but despite this variation, all these people get the same diagnosis. As a result, we think that it is difficult to get a better understanding of the underlying biology of schizophrenia and bipolar disorder simply by studying the average patient. What recommendations do you have for future research as a result of this work?

Response: In practice, psychiatrists and psychologists know very well that each patient is an individual, with his/her own story, history, and biology. Nevertheless, we use diagnostic models that largely ignore these differences. We look at both the symptoms and the biology with the help of our novel methods and can recommend that future research should focus more on the individual patient rather than the patient group. While it is still a long way to go before this research will translate towards clinical utilization, we hope it will lead to better diagnoses and individualized therapies for patients. Is there anything else you would like to add? 

Response: We like to thank all the patients and participants that contributed to this study.


Wolfers T, Doan NT, Kaufmann T, et al. Mapping the Heterogeneous Phenotype of Schizophrenia and Bipolar Disorder Using Normative Models. JAMA Psychiatry. Published online October 10, 2018. doi:10.1001/jamapsychiatry.2018.2467 

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Last Updated on October 11, 2018 by Marie Benz MD FAAD