Schizophrenia and Other Psychoses

Jayendra K. Patel, Debra A. Pinals, Alan Breier, Michael B. First

Research output: Chapter in Book/Report/Conference proceedingChapter

2 Scopus citations

Abstract

Schizophrenia, a chronic and debilitating mental illness, has been one of the most extensively investigated illnesses. Thus, not surprisingly, the first XY pages of this chapter provide a comprehensive update on schizophrenia. This chapter contains two major sections: "schizophrenia" and "other psychoses." The information in schizophrenia section is discussed under the headings of historical overview, diagnosis, epidemiology and sociodemographic information, etiology, pathophysiology, clinical manifestation and phenomenology, differential diagnosis, pharmacological and nonpharmacological treatment, and ends with clinical vignettes. The etiology subsection covers contemporary information on genetics and includes data on perinatal complications and its association with developing schizophrenia. The section on pathophysiology provides current findings from neuroimaging and postmortem studies on structural changes in brain and their relevance to schizophrenia. Any discussion of the etiopathology of schizophrenia would be incomplete without a review of neurochemical underpinnings of the disorder. This subsection provides an overview of dopaminergic and glutamatergic systems role in the manifestation and treatment of schizophrenia and how the "dopamine theory" of schizophrenia has evolved over time. The review of etiopathological relevance of neurotransmitters and neuropeptides leads to a discussion of the biochemical theories of schizophrenia and current thinking on neurodegenerative versus neurodevelopmental origins of schizophrenia as well as neuroprotection. A subsection also reviews the relevance of electrophysiology and sensorimotor gating phenomena to schizophrenia. The clinical manifestation and phenomenology subsection reviews the cognitive dysfunction associated with schizophrenia. As there is no one test that can reliably diagnose schizophrenia, an elaborate discussion of its differential diagnosis is included. In most instances, the course of schizophrenia is chronic and often downhill. The subsection on the course of illness reviews the information on first episode psychosis and the long-term outcome of early and effective intervention. An up-to-date review of current pharmacological management covers both the typical and atypical antipsychotics with a specific focus on the side effects. Even with the introduction of newer antipsychotics, treatment resistance remains a challenge and is covered in this section along with acute and maintenance treatment. Diagnosis and management of comorbid conditions such as major depression are equally important in improving patients' quality of life. Nonpharmacological treatment covers topics such as psychosocial rehabilitation, psychodynamic therapy, individual therapy, group therapy, psychoeducational training, and approaches using cognitive therapy. Family therapy and case management play a crucial role in effective treatment of schizophrenia and especially in combination with medications.

Original languageEnglish (US)
Title of host publicationPsychiatry
Subtitle of host publicationThird Edition
PublisherJohn Wiley & Sons, Ltd
Pages1201-1282
Number of pages82
Volume1
ISBN (Print)9780470065716
DOIs
StatePublished - Aug 8 2008

Keywords

  • Antipsychotics
  • Brief psychotic disorder
  • Delusional disorder
  • Schizoaffective disorder
  • Schizophrenia
  • Schizophreniform disorder
  • Shared psychotic disorder

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Patel, J. K., Pinals, D. A., Breier, A., & First, M. B. (2008). Schizophrenia and Other Psychoses. In Psychiatry: Third Edition (Vol. 1, pp. 1201-1282). John Wiley & Sons, Ltd. https://doi.org/10.1002/9780470515167.ch65