Schizophrenia
Abstract
Schizophrenia is still one of the most mysterious and costliest mental disorders in terms of human suffering and societal expenditure. Here, we focus on the key developments in biology, epidemiology, and pharmacology of schizophrenia and provide a syndromal framework in which these aspects can be understood together. Symptoms typically emerge in adolescence and early adulthood. The incidence of the disorder varies greatly across places and migrant groups, as do symptoms, course, and treatment response across individuals. Genetic vulnerability is shared in part with bipolar disorder and recent molecular genetic findings also indicate an overlap with developmental disorders such as autism. The diagnosis of schizophrenia is associated with demonstrable alterations in brain structure and changes in dopamine neurotransmission, the latter being directly related to hallucinations and delusions. Pharmacological treatments, which block the dopamine system, are effective for delusions and hallucinations but less so for disabling cognitive and motivational impairments. Specific vocational and psychological interventions, in combination with antipsychotic medication in a context of community-case management, can improve functional outcome but are not widely available. 100 years after being so named, research is beginning to understand the biological mechanisms underlying the symptoms of schizophrenia and the psychosocial factors that moderate their expression. Although current treatments…
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Current treatments for schizophrenia only ameliorate psychotic symptoms in some patients and generally fail to improve cognition and other behavioral abnormalities.
“For example, current treatments for schizophrenia only ameliorate psychotic symptoms in some patients and generally fail to improve cognition and other behavioral abnormalities 3 ,”
From Developmental timing and critical windows for the treatment of psychiatric disorders (2016) · cites this paper as [3]
Even with adherence to psychopharmaceutical treatment, psychotic symptoms-especially negative symptoms-often persist.
“Even when patients are compliant to psychopharmaceutical treatment, symptoms, especially negative symptoms, often persist,2,6 and about 30% of patients are therapy refractory.7”
From Mindfulness-and acceptance-based interventions for psychosis: A systematic review and meta-analysis (2016) · cites this paper as [2]
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- Authors
- van Os, J., & Kapur, S.
- Affiliations
- King's College London (GB)
- ORCID
- Kapur, Shitij
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2009-08
- Volume
- 374
- Issue
- 9690
- Pages
- 635-645
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W4211174138
- Cited by
- 1,971
- References
- 13
- Citations by year
- 2026: 47 · 2025: 89 · 2024: 72 · 2023: 74 · 2022: 94 · 2021: 110 · 2020: 163 · 2019: 101 · 2018: 150 · 2017: 135 · 2016: 215 · 2015: 159 · 2014: 128 · 2013: 133 · 2012: 130
- FWCI
- 12.75
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- schizophrenia, dopamine signaling, antipsychotic drugs, genetic susceptibility, bipolar disorder, autism spectrum disorder, brain structure, hallucinations, delusions, cognitive impairment, community case management, vocational rehabilitation, psychosocial interventions, prognosis
- MeSH terms
- Adolescent, Diagnosis, Differential, Humans, Models, Genetic, Models, Psychological, Terminology as Topic, Prognosis, Psychiatric Status Rating Scales, Risk Factors, Schizophrenia, Schizophrenic Psychology, Social Environment, Antipsychotic Agents, Cost of Illness, Age of Onset, Case Management, Genetic Predisposition to Disease, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders, Young Adult
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