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.