What’s New About Schizophrenia?

May 21, 2015

“Those who fail to learn from the mistakes of their predecessors are destined to repeat them.” This may be the take-home point of the APA 2015 meeting regarding schizophrenia.

One of the potential benefits of attending the annual APA meeting is keeping up with advances in psychiatry at one time in one place. One of the topics always highlighted, because it remains so challenging, is schizophrenia. I am more optimistic this year than ever before about what we can do to help reduce the often devastating outcome of those who develop what we call schizophrenia.

What I was looking forward to learning about had been primed by Thomas, Insel, MD, Director of our NIMH. In his Director’s Blog: Best of 2014, Dr Insel briefly ranked and discussed what he thought were the most important mental health stories of 2014. Not surprisingly to me, two were on schizophrenia.

Ranked #5 on Dr Insel’s list was “Schizophrenia Common Variants.” This story focused on the large number of common genetic variants that contribute to the risk of developing schizophrenia. What a change from what I was taught in my psychiatric residency over 40 years ago, when the theory of the double-binding schizophrenogenic mother was still prominent!

Ranked #1 on his list was the story on “RAISE Research to Practice.” Although most psychiatrists who treat those with schizophrenia have always desired to address the disease in its earliest stages, the RAISE research project is attempting to bring together the most cutting-edge research and translate it into everyday practice.

The Recovery After an Initial Schizophrenic Episode (RAISE) is a patient-centered, multi-modal approach for optimizing outcomes after a first psychotic episode. We should be eagerly anticipating the results of the 34 site comparative effectiveness trial. Most clinicians already assume that without effective early intervention in youths, the greater the likelihood is of long-term disability.