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The Evolution of Schizophrenia Research and Treatment
James P. Kelleher*Associate Professor of Clinical Psychiatry and Behavioral Sciences, New York Medical College, USA
Abstract
About 100 years after Kraepelin laid the foundation of the current concept of schizophrenia (Falkai et al., 2015), sadly, much remains to be understood about this disease. As the research domain criteria (Buckley & Miller, 2015) are gradually being utilized, perhaps significantly altering our understanding of schizophrenia, work continues, increasingly using novel approaches – particularly the application of genetics and new technologies. Many markers have been linked with schizophrenia but findings do not support a full genetic “profile.” (Chen et al., 2015) Neuroimaging technologies in particular have illuminated common areas of abnormalities including altered structural integrity of white matter in frontal and temporal brain regions and altered structural relationships among regional morphology in the thalamus, frontal, temporal and parietal cortices (Wheeler & Voineskos, 2014), while more research is needed to further define progressive changes and response to medication. Pharmacologically, we have progressed to a third generation of antipsychotics (Kelleher, 2004), although the challenges of balancing efficacy and side effects, particularly within the framework of cost efficient care is a significant issue. Clozapine remains the most efficacious antipsychotic although its most essential pharmacologic characteristic remains inadequately understood (Dold & Leucht, 2014). The best treatment of patients with schizophrenia involves not only psychopharmacology and psychotherapy but also attention to nonpsychiatric medical issues (Shulman, Miller, Misher & Tentler, 2014).
