Schizophrenia and Other Psychotic Disorders

Richard L. Munich, M.D.; Carol A. Tamminga, M.D.
DOI: 10.1176/appi.books.9781585622986.265156
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Schizophrenia presents as a heterogeneous and phasic illness, with disabilities affecting perception, cognition, language, memory, emotion, volition, and social and adaptive behaviors. The current formulation about its pathophysiology posits neuroanatomic and neurochemical abnormalities that can be either genetically or environmentally induced. These neurobiological substrates can produce vulnerability in a particular person that makes him or her sensitive to a variety of psychosocial and physical stressors. When a stressor coincides with the vulnerability, occasionally early in life but usually in late adolescence or early adulthood, afflicted persons develop a steadily worsening cascade of changes in their neurochemical, cognitive, and interpersonal structures. Full recovery from these changes is the exception rather than the rule. This complex view of the schizophrenic process has moved treatment from a rigid dichotomy between somatic and psychosocial approaches to the more broadly integrated but highly focused biopsychosocial interventions detailed in the three chapters in this section.

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