Schizophrenia affects about 1% of the world population, and another 2% to 3% experience milder forms of symptoms and related impairments. It is a lifelong serious condition that strikes individuals early (late teens to early 20s) and leads to a life of frequent hospitalizations, suicide attempts (approximately 10% of patients die of suicide), social alienation, unemployment, poverty, homelessness, and early death.
Other than success with treating overt psychosis, there are no effective treatments for most aspects of schizophrenia psychopathology and functional impairments. Progress in under-standing the schizophrenia spectrum disorders has posed a difficult challenge for years. However, recently there have been interesting developments: research has branched into several new directions and has yielded new knowledge.
For instance, there has been an increasing interest in identifying at-risk individuals and implementing early intervention strategies to reduce functional impairments and improve the course of the disorder. Thomas H. McGlashan, MD, summarizes this literature and includes findings from long-term follow-up studies. He also provides practical suggestions for managing symptoms that are likely to be antecedents of schizophrenia.
Irene M. Hurford, MD, Solomon Kalkstein, PhD, and Matthew O. Hurford, MD, summarize the extent of cognitive impairments in schizophrenia and their functional consequences. They then provide interesting strategies to treat cognitive impairment with cognitive remediation techniques.
Clinicians have long recognized that many of the psychiatric disorders lack clear boundaries, and that there is a substantial overlap in phenomenology and etiopathophysiology of various disorders. In an interesting article, Yael Dvir, MD, and Jean A. Frazier, MD, examine the degree of overlap between autism and childhood-onset schizophrenia in clinical features, neurobiology, and genetics.
Together these 3 articles summarize some of the exciting developments in schizophrenia spectrum disorders that are likely to affect our clinical practice.