Written by experts in the field who have a track record of being engaging authors, this book provides a rapid overview of the current state of the art in schizophrenia research and clinical management. It will be invaluable to all psychiatrists, psychologists, neuropharmacologists, researchers in psychiatry and psychopharmacology in academia and in industry, and clinical and behavioural neuroscientists.
Table of Contents
List of Contributors.Preface.
1 Diagnosis and revision of the classification systems (Assen Jablensky).
Introduction.
Origin and evolution of the concept of schizophrenia.
Kraepelin's 'clinical forms'.
Bleuler's 'group of schizophrenias'.
Leonhard's 'endogenous psychoses'.
Classification of psychoses in French psychiatry.
Other post-Kraepelinian and post-Bleulerian subtypes and dichotomies.
The schizophrenia spectrum concept.
Statistically derived clusters and symptom dimensions.
Schizophrenia in ICD-10 and DSM-IV.
Origins of the two classifications.
Both DSM-IV and ICD-10 are descendants of the Kraepelinian nosology.
Criteria for assessing the diagnostic classification of schizophrenia.
Positive impact and unintended adverse effects.
Clinical relevance and cognitive ease of use.
Utility in research.
Reliability.
Concepts of validity.
Predictive validity: course and outcome.
Criterion validity: genetics.
Aspects of culture.
Reducing stigma.
Revision of the classifications: prospects for schizophrenia.
One classification or many?
Critical issues in the revision process.
Disease or a broad syndrome?
'Deconstructing' schizophrenia: categories or dimensions?
Endophenotypes.
The concept of utility.
Conclusion.
References.
2 Pathophysiology of schizophrenia (Peter Falkai, Andrea Schmitt and Tyrone D. Cannon).
Introduction.
Major findings and related pathophysiological hypotheses.
Symptom domains and neurotransmitter hypotheses.
From domains to disturbed neuronal networks.
From networks to the cellular level.
Hypothesis of disturbed synaptogenesis and neurogenesis.
Effects of antipsychotics.
Summary and conclusions.
References.
3 Neurocognition, social cognition and functional outcome in schizophrenia (William P. Horan, Philippe-Olivier Harvey, Robert S. Kern and Michael F. Green).
Introduction.
Neurocognition in schizophrenia.
Domains, measurement and magnitude of impairment.
Neurocognition as a core deficit of schizophrenia.
Associations with functional outcome.
The NIMH-MATRICS initiative and current research directions.
Social cognition.
Domains, measurement and magnitude of impairment.
Social cognition as a core feature of schizophrenia.
Association with functional outcome.
Current research directions.
Relationships among neurocognition, social cognition and functional outcome.
Distinctiveness of neurocognition and social cognition.
Social cognition as a mediator.
Future directions.
References.
4 The genetics of schizophrenia (James T.R. Walters, Michael O'Donovan and Michael J. Owen).
Introduction.
Genetic epidemiology of schizophrenia.
Family, twin and adoption studies of schizophrenia.
Genetic epidemiology – informing diagnosis?
Molecular genetics of schizophrenia.
Linkage.
Positional candidate studies.
Functional candidate studies.
Chromosomal abnormalities.
Genome wide association studies.
GWAS in schizophrenia.
Copy number variation.
The future of schizophrenia genetics.
Schizophrenia genetics in the clinic?
Conclusions.
Acknowledgements.
References.
5 Early recognition and prevention of schizophrenia (Patrick D. McGorry and Sherilyn Goldstone).
The context for early recognition and prevention.
The prodromal stage: definition and assessment.
Treatment during the prodromal stage.
The psychosis risk syndrome: a novel diagnostic entity?
Ethical issues.
Summary and conclusions.
References.
6 Pharmacological treatment (Jonathan E. Sherin and Stephen R. Marder).
Introduction.
Current state of pharmacological treatment.
Phases of schizophrenia.
Acute phase treatment.
Stabilization phase treatment.
Maintenance phase treatment.
Treatment resistant patients.
Managing first episodes.
Newer antipsychotics.
Personalising drug treatment in schizophrenia.
Cognition and negative symptoms as therapeutic targets.
Glutamatergic targets.
Dopamine targets.
Cholinergic targets.
Histamine targets.
Summary.
References.
7 Cognitive-behavioural interventions (Suzanne Jolley and Philippa Garety).
Introduction.
The development of cognitive behavioural approaches to schizophrenia-spectrum psychosis.
Cognitive behavioural models of psychosis.
Biopsychosocial vulnerability.
Life events and schematic beliefs.
The role of affect.
The central role of appraisal.
Reasoning biases.
Anomalous experiences.
The role of behaviour.
Insight and illness appraisals.
Cognitive behavioural therapy in schizophrenia.
Psychotherapy in schizophrenia: more than unspecific learning?
Combining psychotherapy and pharmacotherapy.
Efficacy of cognitive behavioural therapy for psychosis (CBTp).
Future developments.
Conclusions.
Acknowledgements.
References.
8 Management, rehabilitation, stigma (Wulf Rossler).
Introduction.
Managing schizophrenia: integrative approaches.
Burden for patients, families and communities.
Gender issues.
Mortality.
Legal problems.
Health care settings for schizophrenia patients: which setting is optimal?
Psychiatric rehabilitation.
The international classification of functioning, disability and health.
Target population.
Conceptual framework.
Current approaches.
Individual-centred rehabilitation.
Cognitive behavioural therapy.
Social skills training.
Ecological approach to rehabilitation.
Housing.
Work.
Participation in community life with full rights.
The contribution of mental health professionals to stigma and discrimination.
The role of the psychiatrist in the management and rehabilitation of schizophrenia patients.
Outlook.
References.
Index.
