Hostname: page-component-8448b6f56d-tj2md Total loading time: 0 Render date: 2024-04-23T13:50:19.675Z Has data issue: false hasContentIssue false
  • English
  • Français

Schizophrenia: An Overview

Published online by Cambridge University Press:  06 October 2014

I. Harry Minas ,
Henry Jackson ,
Peter Doherty  and
Pat McGorry
I. Harry Minas*
Affiliation:
Aubrey Lewis Clinical Research Unit, Royal Park Psychiatric Hospital
Henry Jackson
Affiliation:
Department of Clinical Psychology, Royal Park Psychiatric Hospital
Peter Doherty
Affiliation:
Psychiatrist Superintendent, Plenty Hospital
Pat McGorry
Affiliation:
Aubrey Lewis Clinical Research Unit, Royal Park Psychiatric Hospital
*
Aubrey Lewis Clinical Research Unit, Royal Park Psychiatric Hospital, Royal Park, Vic. 3052
Get access

Abstract

An overview of schizophrenia is presented. The epidemiology and clinical features of this common but serious psychiatric disorder are outlined. Four case vignettes illustrate different presentations and, to some extent, the varying course of the disorder. Diagnostic issues are discussed and the heterogeneity of the disorder highlighted. The major aetiological hypotheses are outlined, including evidence for genetic and biochemical involvement, the role of family, social and personality factors, psychological mechanisms and life events. A diathesis-stress view is presented, in which biological vulnerability and psychological and environmental factors are necessary for the development of the clinical disorder. Somatic and psychosocial treatments are briefly discussed as are the course, possible outcomes and factors affecting prognosis. Finally some future research directions in both the biological and psychosocial areas are considered.

Type
Articles
Information
Behaviour Change , Volume 2 , Issue 2 , June 1985 , pp. 80 - 93
Copyright
Copyright © The Author(s) 1985

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders-Third Edition, (DSM-III). Washington, D.C.: American Psychiatric Association.Google Scholar
Andrews, G., Hall, W., Goldstein, G., Lapsley, H., Bartels, R. & Silove, D. (1985). The economic costs of schizophrenia. Archives of General Psychiatry, 42, 537–543.Google Scholar
Baldessarini, R. (1977). Chemotherapy in psychiatry. Cambridge, Mass.: Harvard University Press.Google Scholar
Bleuler, M. (1911). (English edition, 1950). Dementia praecox or the group of schizophrenias. New York: International University Press.Google Scholar
Bleuler, M. (1974). The long term course of the schizophrenic psychoses. Psychological Medicine, 4, 244–254.CrossRefGoogle Scholar
Brown, G.M. & Birley, J.L.T. (1968). Crisis and life changes at the onset of schizophrenia. Journal of Health and Social Behaviour, 9, 203–224.Google Scholar
Brown, G.W., Bone, M., Dahison, B. & Wing, J.K. (1966). Schizophrenia and social care. Maudsley Monograph 17. London: Oxford University Press.Google Scholar
Cameron, N. (1938). Reasoning, regression and communication in schizophrenia. Psychological Monographs, 50, 1–34.Google Scholar
Carpenter, W.T. & Stephens, J.H. (1979). An attempted integration of information relevant to schizophrenic subtypes. Schizophrenia Bulletin, 5, 490–506.Google Scholar
Carpenter, W.T., Strauss, J.S. & Muleh, S. (1973). Are there pathognomomic symptoms of schizophrenia? An empirical investigation of Schneider's first rank symptoms. Archives of General Psychiatry, 28, 847–872.Google Scholar
Connell, P.H. (1958). Amphetamine psychosis. Maudsley Monograph No. 5. London: Oxford University Press.Google Scholar
Cooper, B. (1978). Epidemiology. In Wing, J.K. (Ed.), Schizophrenia: Towards a new synthesis. London: Academic Press.Google Scholar
Cooper, J.E., Kendell, R.E., Gurland, B.J., Sharpe, L., Copeland, J.R.M. & Simon, R. (1972). Psychiatric diagnosis in New York and London. Maudsley Monograph No. 20. London: Oxford University Press.Google Scholar
Crow, T.J. (1980). Molecular pathology of schizrophenia: More than one disease process? British Medical Journal, 66–68.Google Scholar
Crow, T.J., Cross, A.J., Johnstone, E.C. & Owen, F. (1982). Two syndromes in schizophrenia and their pathogenesis. In Henn, F.A. and Masrallah, H.A. (Eds.), Schizophrenia as a brain disease. New York: Oxford University Press.Google Scholar
Dadds, M., Dooley, R. & Pakenham, K. (1985). Behavioural family interventions in the management of schizophrenia: A review. Behaviour Change, 2, 102–110.Google Scholar
Davis, J.M. (1975). Overview: Maintenance therapy in psychiatry 1. Schizophrenia. American Journal of Psychiatry, 132, 1237–1245.Google Scholar
Davis, J.M., Schaffer, C.B., Killiam, G.A., Kinard, C. & Chan, C. (1980). Important issues in the drug treatment of schizophrenia. Schizophrenia Bulletin, 60, 70–87.CrossRefGoogle Scholar
Dawson, M.E. & Nuechterlein, K.H. (1984). Psychophysiological dysfunctions in the developmental course of schizophrenic disorders. Schizophrenia Bulletin, 10, 204–232.Google Scholar
Deveson, A. (1985). Stimulating community interest and involvement in the problem of schizophrenia. Paper presented at the symposium The enigma of schizophrenia: An Australian perspective. ANZAAS Festival of Science, Monash University.Google Scholar
Dooley, R.T. & Dadds, M.R. (1985). Issues in the reciprocal influence of schizophrenia and the family. In Proceedings of the Eighth Annual Conference of the Australian Behaviour Modification Association. Melbourne: Australian Behaviour Modification Association.Google Scholar
Falloon, I.R.H., Boyd, J.L. & McGill, C.W. (1984). Family care in schizophrenia: A problem-solving approach to the treatment of mental illness. New York: Guilford.Google Scholar
Faris, R.E.L. & Dunham, H.W. (1939). Mental disorders in urban areas: An ecological study of schizophrenia and other psychoses. Chicago: University of Chicago Press.Google Scholar
Gelder, M., Gath, D. & Mayou, R. (1983). Oxford textbook of psychiatry. Oxford: Oxford University Press.Google Scholar
George, L. & Menfield, R.W.J. (1985). Cognition and symptomatology in schizophrenia. Schizophrenia Bulletin, 11, 264–285.CrossRefGoogle ScholarPubMed
Goldberg, E.M. & Morrison, S.L. (1963). Schizophrenia and social class. British Journal of Psychiatry, 109, 785–802.Google Scholar
Goldstein, K. (1944). Methodological approach to the study of schizophrenic thought disorder. In Kasanin, J.S. (Ed.), Language and thought in schizophrenia. Berkeley: University of California Press.Google Scholar
Gomes-Schwartz, B. (1984). Individual psychotherapy of schizophrenia. In Bellack, A.S. (Ed.), Schizophrenia: Treatment, management, and rehabilitation. New York: Grune and Stratton.Google Scholar
Hare, E.H. (1956). Family setting and the urban distribution of schizophrenia. Journal of Mental Science, 102, 753–760.Google Scholar
Harrow, M., Grossman, L.S., Silverstein, M.L. & Meitzer, H.Y. (1982). Thought disorder in manic and schizophrenic patients. Archives of General Psychiatry, 39, 665–671.Google Scholar
Hecker, E. (1871). Die hebephrenie. Archiv fur pathologische anatomie und physiologie und klinische medizin, 52, 394–429.Google Scholar
Heston, L.L. (1966). Psychiatric disorders in foster home raised children of schizophrenic mothers. British Journal of Psychiatry, 112, 819–825.Google Scholar
Hirsch, S.R. (1980). Current trends in the medical treatment of schizophrenia. In Tennent, T.G. (Ed.), Current trends in treatment in psychiatry. London: Pitman Medical.Google Scholar
Hollister, L. (1978). Psychopharmacology. In Ghershaw, J. (Ed.), Schizophrenia, science and practice. Cambridge, Mass.: Harvard University Press.Google Scholar
Jackson, H.J. & Minas, I.H. (1985). Subtypes of schizophrenia and their implications for social skills training. In Proceedings of the Eighth Annual Conference of the Australian Behaviour Modification Association. Melbourne: Australian Behaviour Modification Association.Google Scholar
Kahlbaum, K.L. (1974). Die katatonie oder das spannungsirresein. Berlin: Hirschwald.Google Scholar
Keith, S.J. & Mathews, S.M. (1982). Group, family, and milieu therapies and psychosocial rehabilitation in the treatment of schizophrenic disorders. In Grinspoon, L. (Ed.), Psychiatry 1982: Annual review. Washington, D.C.: American Psychiatric Press.Google Scholar
Keith, S.J. & Mathews, S. (1984). Group psychotherapy. In Beilack, A.S. (Ed.), Schizophrenia: Treatment, management, and rehabilitation. New York: Grune and Stratton.Google Scholar
Kety, S.S., Rosenthal, D., Wender, P.H. & Schulsinger, F. (1968). The types and prevalence of mental illness in the biological and adoptive families of adopted schizophrenics. In Rosenthal, D. and Kety, S.S. (Eds.), The transmission of schizophrenia. New York: Pergamon.Google Scholar
Kety, S.S., Rosenthal, D., Wender, P.H., Schulsinger, F. & Jacobsen, B. (1975). Mental illness in the biologic and adoptive families of adopted individuals who have become schizophrenic. In Fieve, R.R., Rosenthal, D. and Bull, H. (Eds.), Genetic research in psychiatry. Baltimore: John Hopkins University Press.Google Scholar
Knight, R.A., Roff, J.D.Barnett, J. & Moss, J.L. (1979). Concurrent and predictive validity of thought disorder and affectivity: A 22-year follow-up of acute schizophrenics. Journal of Abnormal Psychology, 88, 1–12.Google Scholar
Kolakowska, T., Williams, A.O., Ardern, M., Reveley, M.A., Jambor, K., Gelder, M.G. & Mandelbrote, B.M. (1985). Schizophrenia with good and poor outcome: I. Early clinical features, response to neuroleptics and signs of organic dysfunction. British Journal of Psychiatry, 146, 229–246.Google Scholar
Kraepelin, E. (1919). Dementia praecox and paraphrenia. Edinburgh: Livingstone.Google Scholar
Leff, J., (1985). Social factors and maintenance neuroleptics in schizophrenic relapse: An integrative model. Integrative Psychiatry, 3, 72–88.Google Scholar
Lehmann, H.E. & Cancro, R. (1985). Schizophrenia: Clinical features. In Kaplan, H.I. and Sadock, B.J. (Eds.), Comprehensive textbook of psychiatry (Fourth Edition). Baltimore: Williams and Wilkins.Google Scholar
Liberman, R.P., Marshall, B.D. Jnr., Marder, S.R., Dawson, M.E., Nuechterlein, K.H. & Doane, J.A. (1984). The nature and problem of schizophrenia. In Bellack, A.S. (Ed.), Schizophrenia: Treatment, management and rehabilitation. New York: Grune and Stratton.Google Scholar
Matson, J.L. (1980). Behavior modification procedures for training chronically institutionalized schizophrenics. In Hersen., M., Eisler, R.M. and Miller, P.M. (Eds.), Progress in Behavior Modification (Vol. 9). New York: Academic Press.Google Scholar
Miller, R.J., Horn, A.S. & Iversen, L.L. (1974). The action of neuroleptic drugs on dopamine — stimulated adenosine cycle 3'5' monophosphate production in rat neostriatum and limbic forebrain. Molecular Pharmacology, 10, 759–766.Google Scholar
Morel, B.A. (1860). Truite' des maladie mentales. Masson, Paris. Cited in Gelder, M., Gath, D. and Mayou, R. (1983). Oxford textbook of psychiatry. Oxford: Oxford University Press.Google Scholar
Morrison, J.R., Winokur, G., Crowe, R. & Clancey, J. (1973). The Iowa 500: The first followup. Archives of General Psychiatry, 29, 678.Google Scholar
Murphy, H.B.M. & Roman, A.C. (1971). The chronicity of schizophrenia in indigenous tropical people. British Journal of Psychiatry, 118, 489–497.CrossRefGoogle Scholar
Myerson, A. (1940). Review of Mental disorders in urban areas: An ecological study of schizophrenia and other psychoses. American Journal of Psychiatry, 96, 995–997.Google Scholar
Neale, J.M. & Oltmanns, T.F. (1980). Schizophrenia. New York: Wiley.Google Scholar
Neale, J.M., Oltmanns, T.F. & Harvey, P.D. (1985). The need to relate cognitive deficits to specific behavioral referents of schizophrenia. Schizophrenia Bulletin, 11, 286–291.Google Scholar
Neisser, U. (1967). Cognitive psychology. New York: Appleton-Century-Crofts.Google Scholar
Nuechterlein, K.H. & Dawson, M.E. (1984). Information processing and attentional functioning in the developmental course of schizophrenic disorders. Schizophrenia Bulletin, 10, 160–203.CrossRefGoogle ScholarPubMed
Payne, R.W. (1962). An object classification test as a measure of over-inclusiveness in schizophrenic patients. British Journal of Social and Clinical Psychology, 1, 213–221.CrossRefGoogle Scholar
Pfohl, B. & Winokur, G. (1982). Schizophrenia: Course and outcome. In Henn, F.A. and Masrallah, H.A. (Eds.), Schizophrenia as a brain disease. New York: Oxford University Press.Google Scholar
Rosenthal, D., Wenders, P.H., Kety, S.S., Welner, J. & Schulsinger, F. (1971). The adopted away offspring of schizophrenics. American Journal of Psychiatry, 128, 307–311.Google Scholar
Roy, A. (1982). Suicide in chronic schizophrenia. British Journal of Psychiatry, 141, 171–172.Google Scholar
Royal Australian and New Zealand College of Psychiatrists. (1984). Quality Assurance Project: Treatment outlines for the management of schizophrenia. Australian and New Zealand Journal of Psychiatry, 18, 19–38.Google Scholar
Sander, W. (1868). Uber eine spezielle Form der primaren Verrucktheit. Archiv fur Psychiatrie und Nerven Krankheiten, vereinigt mit Zeitschreft fur die gezante Neurologie und Psychiatrie, I, 387–419.Google Scholar
Schneider, K. (1959). Clinical psychopathology, (Fifth Edition). New York: Grune and Stratton.Google Scholar
Seeman, P. & Lee, T. (1975). Antipsychotic drugs: Direct correlation between clinical potency and presynaptic actions on dopamine neurons. Science, 188, 1217–1219.Google Scholar
Shields, J. (1978). Genetics. In Wing, J.K. (Ed.), Schizophrenia: Towards a new synthesis. London: Academic Press.Google Scholar
Shopsin, B., Kim, S.S. & Gershon, S.A. (1971). A controlled study of lithium vs. chlorpromazine in acute schizophrenics. British Journal of Psychiatry, 119, 435–440.Google Scholar
Slater, E. & Cowie, V. (1971). The genetics of mental disorders. London: Oxford University Press.Google Scholar
Snyder, S.H. (1976). The dopamine hypothesis of schizophrenia: Focus on the dopamine receptor. American Journal of Psychiatry, 133, 197–202.Google Scholar
Spitzer, F.L., Endicott, J. & Robins, E. (1978). Research diagnostic criteria: Rationale and reliability. Archives of General Psychiatry, 35, 773–782.Google Scholar
Strauss, J.S., Carpenter, W.T. & Bartko, J.J. (1974). Speculation on the processes that underline schizophrenic symptoms and signs. Schizophrenia Bulletin, 11, 61–73.Google Scholar
Taylor, P.J. & Fleminger, J.J. (1980). ECT for schizophrenia. Lancet, i, 1380–1382.Google Scholar
Venables, P.H. (1964). Input dysfunction in schizophrenia. In Maher, B.A. (Ed.), Progress in experimental personality research (Vol. 1). New York: Academic Press.Google Scholar
Waxler, N.E. (1979). Is outcome for schizophrenia better in non-industrial societies. Journal of Nervous and Mental Disease, 167, 144–158.CrossRefGoogle Scholar
Weinberger, D.R., Bigelow, L.B., Kleinman, J.E., Klein, S.T., Rosenblatt, J.E. & Wyatt, R.J. (1980). Cerebral ventricular enlargement in chronic schizophrenia: An association with poor response to treatment. Archives of General Psychiatry, 37, 11–14.Google Scholar
Weiner, H. (1985). Schizophrenia: Aetiology. In Kaplan, H.I. and Sadock, B.J. (Eds.), Comprehensive textbook of psychiatry (Fourth Edition). Baltimore: Williams and Wilkins.Google Scholar
World Health Organization (1973). Report of the International Pilot Study of Schizophrenia (Vol. 1). Geneva: World Health Organization.Google Scholar
World Health Organization. (1979). Schizophrenia: An initial follow up. Chichester: Wiley.Google Scholar