Schizophrenia
Schizophrenia
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DOI：
10.1038/nrdp.2015.67
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发表时间：
2015-11-12
影响因子：
81.5
通讯作者：
Insel, Thomas R.
中科院分区：
文献类型：
--
作者：
Kahn, Rene S.;Sommer, Iris E.;Insel, Thomas R.
精神分裂症是一种慢性精神疾病，具有影响早期大脑发育的异质遗传和神经生物学背景，并表现为精神病性障碍（如幻觉、妄想和混乱）以及动机和认知功能障碍的组合。该疾病的平均终生患病率略低于1%，但由于城市化和移民模式的差异，患病率的区域差异很明显。虽然大体的脑病理学不是精神分裂症的特征，但这种疾病涉及特定神经细胞群和细胞间通讯的微妙病理学变化。精神分裂症，作为一种认知和行为障碍，最终是关于大脑如何处理信息。事实上，神经影像学研究表明，首次发作和慢性精神分裂症患者的信息处理功能异常。虽然精神分裂症的药物治疗可以缓解精神病症状，但这些药物通常不会导致社会，认知和职业功能的实质性改善。心理社会干预措施，如认知行为疗法、认知补救和辅助教育和就业，增加了治疗价值，但应用不一致。鉴于精神分裂症通常在诊断之前多年就开始了，识别处于风险中的个体和处于疾病早期阶段的个体以及探索预防方法至关重要。
Schizophrenia is a chronic psychiatric disorder with a heterogeneous genetic and neurobiological background that influences early brain development, and is expressed as a combination of psychotic symptoms-such as hallucinations, delusions and disorganization-and motivational and cognitive dysfunctions. The mean lifetime prevalence of the disorder is just below 1%, but large regional differences in prevalence rates are evident owing to disparities in urbanicity and patterns of immigration. Although gross brain pathology is not a characteristic of schizophrenia, the disorder involves subtle pathological changes in specific neural cell populations and in cell-cell communication. Schizophrenia, as a cognitive and behavioural disorder, is ultimately about how the brain processes information. Indeed, neuroimaging studies have shown that information processing is functionally abnormal in patients with first-episode and chronic schizophrenia. Although pharmacological treatments for schizophrenia can relieve psychotic symptoms, such drugs generally do not lead to substantial improvements in social, cognitive and occupational functioning. Psychosocial interventions such as cognitive-behavioural therapy, cognitive remediation and supported education and employment have added treatment value, but are inconsistently applied. Given that schizophrenia starts many years before a diagnosis is typically made, the identification of individuals at risk and those in the early phases of the disorder, and the exploration of preventive approaches are crucial.