Abstract
Schizophrenia is one of the major diagnostic and treatment challenges in medicine. Although approx 1% of the population suffers from schizophrenia, available treatments remain symptomatic and rarely allow for a full functional recovery. This results in a large burden for persons afflicted with schizophrenia, their families, and the society at large.
We have made progress in reliably diagnosing schizophrenia and in exploring the neural basis of schizophrenia. Neural circuits involving dopaminergic, glutamatergic, and g-aminobutyric acid (GABA)ergic neurons in prefrontal cortical regions, in the temporal lobe, and in the thalamus are involved in mediating the psychotic features and the cognitive deficits of schizophrenia. Studies of this emerging neural circuitry include the mapping of brain structure and function in patients, the quantification of cellular and molecular changes in postmortem specimens, and the validation of changes in animal models of schizophrenia. Recently, several risk genes for schizophrenia have been identified, providing specific targets for the development of diagnostic tests and therapeutic interventions.
In this chapter, we review basic concepts of the clinical presentation, the neural and genetic basis, and the pharmacological treatment of schizophrenia.
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References
Kendler KS, Karkowski LM, Walsh D. The structure of psychosis: latent class analysis of probands from the Roscommon Family Study [see comments]. Arch Gen Psychiatry 1998;55: 492–499.
Kirkpatrick B, Buchanan RW, Ross DE, Carpenter WI. A separate disease within the syndrome of schizophrenia. Archives of General Psychiatry 2001;58:165–171.
Slade PD, Bentall RP. Sensory Deception. A scientific analysis of hallucination. 1 ed. Baltimore & London: The Johns Hopkins University Press, 1988.
Sims A. Symptoms in the mind. An introduction to descriptive psychopathology. London: W.B. Saunders, 1999.
Gloor P. The temporal lobe and limbic system. New York, NY: Oxford University Press, 1997.
Grace AA. Phasic versus tonic dopamine release and the modulation of dopamine system responsivity: a hypothesis for the etiology of schizophrenia. Neuroscience 1991;41:1–24.
Konradi C, Heckers S. Molecular aspects of glutamate dysregulation: implications for schizophrenia and its treatment. Pharmacology & Therapeutics 2003;97:153–179.
Wooley D, Shaw E. A biochemical and pharmacological suggestion about certain mental disorders. Proc. Natl. Acad. Sci. 1954;40:228–231.
Tarazi FI, Zhang K, Baldessarini RJ. Long-term effects of olanzapine, risperidone, and quetiapine on serotonin 1A, 2A and 2C receptors in rat forebrain regions. Psychopharmacology 2002;161: 263–270.
Lopez-Figueroa AL, Norton CS, Lopez-Figueroa MO, et al. Serotonin 5-HT1A, 5-HT1B, and 5-HT2A receptor mRNA expression in subjects with major depression, bipolar disorder, and schizophrenia. Biol Psychiatry 2004;55: 225–233.
Roth BL, Hanizavareh SM, Blum AE. Serotonin receptors represent highly favorable molecular targets for cognitive enhancement in schizophrenia and other disorders. Psychopharmacology (Berl) 2003;174:17.
Benes FM, Berretta S. Gabaergic interneurons: Implications for understanding schizophrenia and bipolar disorder. Neuropsychopharmacology 2001;25:1–27.
Weiss AP, Heckers S. Neuroimaging of hallucinations: a review of the literature. Psychiatry Research: Neuroimaging 1999;92:61–74.
Kilts CD. The changing roles and targets for animal models of schizophrenia. Biol Psychiatry 2001;50:845–855.
Berretta S, Lange N, Bhattacharyya S, Sebro R, Garces J, Benes FM. Long Term Effects of Amygdala GABA Receptor Blockade on Specific Subpopulations of Hippocampal Interneurons. Hippocampus 2004;14:876–894.
Swerdlow NR, Braff DL, Geyer MA. Animal models of deficient sensorimotor gating: what we know, what we think we know, and what we hope to know soon. Behav Pharmacol 2000;11: 185–204.
Lipska BK, Weinberger DR. To model a psychiatric disorder in animals: schizophrenia as a reality test. Neuropsychopharmacology 2000;23:223–239.
O’Donovan MC, Williams NM, Owen MJ. Recent advances in the genetics of schizophrenia. Human Molecular Genetics 2003;12:R125–R133.
Egan MF, Goldberg TE, Kolachana BS, et al. Effect of COMT Val108/158 Met genotype on frontal lobe function and risk for schizophrenia. Proceedings of the National Academy of Sciences of the United States of America. 2001; 98:6917–6922.
Davis JM, Chen N, Glick ID. A meta-analysis of the efficacy of second-generation antipsychotics. Archives of General Psychiatry 2003;60:553–564.
Goff DC, Freudenreich O, Evins AE. Augmentation strategies in the treatment of schizophrenia. CNS Spectrums 2001;6:904–911.
Harris EC, Barraclough B. Suicide as an outcome for mental disorders: a meta-analysis. British Journal of Psychiatry 1997;170:205–228.
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© 2005 Humana Press Inc., Totowa, NJ
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Heckers, S., Berretta, S. (2005). Schizophrenia. In: Tarazi, F.I., Schetz, J.A. (eds) Neurological and Psychiatric Disorders. Current Clinical Neurology. Humana Press. https://doi.org/10.1385/1-59259-856-0:111
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DOI: https://doi.org/10.1385/1-59259-856-0:111
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