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Natural history of schizophrenia may inform emerging treatments, preventive measures
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Emerging research on the development, prodromal characteristics and long-term course of schizophrenia may contribute to developing new treatments and preventive measures for schizophrenia, according to an issue of Harvard Review of Psychiatry.
“This special issue of the Harvard Review of Psychiatry brings together global experts in the epidemiology, neurobiology, and treatment of schizophrenia to reevaluate the natural history of the illness and to elaborate priorities for new interventions,” guest editor Joshua L. Roffman, MD, MMSc, of Harvard Medical School and the department of psychiatry at Massachusetts General Hospital, wrote in the issue’s introduction. “Our updated ‘biography’ of schizophrenia incorporates critical reviews of recent key findings from genomics, neuroimaging, electrophysiology, and clinical trials. In aggregate, this work suggests that the architecture of schizophrenia is in the midst of a gut renovation: its frame of core concepts remains largely intact, but the details of its clinical course (especially early on) and underlying neurobiology are rapidly evolving, with important treatment implications.”
The issue includes eight articles that highlight progress toward understanding the development and course of schizophrenia. Specific advances include:
validation of disconnectivity of schizophrenia via modern genetic and brain imaging techniques;
renewed focus on the schizophrenia prodrome, which has enabled identification of youth at clinical high risk and provides the potential to develop interventions to prevent or delay schizophrenia development; and
detection of risks among children of parents with schizophrenia.
The issue also illustrates new approaches to understanding the complexity and variability of schizophrenia over time, including:
how to assess the long-term course of schizophrenia;
viability of electroencephalography to show genetically mediate patterns of brain activity in schizophrenia; and
updated research that suggests dysfunctional voice processing may explain auditory and verbal hallucinations in schizophrenia.
The issue describes new directions in treatment of schizophrenia, including cognitive remediation, a psychological treatment to improve thinking skills, and emerging preventative treatments and supplements such as B vitamins and omega-3 fatty acids.
“The critical reappraisal of the natural history of schizophrenia, and the related insights around new intervention strategies ... provide every reason to be optimistic,” Roffman concluded. – by Amanda Oldt
For more information:
To view the full issue, visit http://journals.lww.com/hrpjournal/pages/currenttoc.aspx.
Disclosure: Roffman reports receiving research support and a consulting honorarium from Pamlab for unrelated projects. Please see the full issue for a list of all authors’ relevant financial disclosures.