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Unmet Needs in Patients with Schizophrenia

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New Directions in Psychiatry

Abstract

There have been huge advances in knowledge of the core biology and treatment of the schizophrenia syndrome in the 70 years since the serendipitous discovery of chlorpromazine, the first effective treatment for a major component of the disorder, and the ensuing elucidation of role of neurotransmitters, neuromodulators, neurodevelopmental abnormalities, genetic, epigenetic and environmental factors, especially stress and stress hormones, in producing the major phenotypic features of the illness. The latter are cognitive impairment (CI), positive, negative, and mood symptoms. Current thinking emphasizes these components of the disorder as targets for improving outcome because they may vary in severity and temporal nature within and between patients. These four components of the illness are not unique to schizophrenia nor are many of the therapies and schizophrenia risk genes. Because of its early onset, devastating effect on normal activities, high rate of suicide, high prevalence (~1% of adult population), and the limited ability of current treatments to fully control these component of the syndrome in the majority of patients, there is an urgent need to apply current treatments more effectively, to develop novel treatments when current treatments are ineffective. We emphasize here the need to target the cognitive impairment associated with schizophrenia, the high suicide rate, and to develop biomarkers which inform choice of and duration of antipsychotic drug treatment.

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Disclosures

HYM is a shareholder of ACADIA and has received grant support from ACADIA, Allergan, Astellas, Eli Lilly, Janssen, Lundbeck, Neurocrine, and Otsuka. The author acknowledges contribution from the Price and Weisman families which facilitated the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Pharmacology and Physiology, Northwestern Feinberg School of Medicine, Chicago, IL, USA

    Herbert Y. Meltzer

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  1. Herbert Y. Meltzer
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Correspondence to Herbert Y. Meltzer .

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Editors and Affiliations

  1. Department of Neurosciences Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy

    Maurizio Pompili

  2. University Health Network, University of Toronto, Toronto, ON, Canada

    Roger McIntyre

  3. Department of Psychiatry, University of Campania “L. Vanvitelli”, Naples, Italy

    Andrea Fiorillo

  4. Association for the Improvement of Mental Health Programmes (AMH), Geneva, Geneve, Switzerland

    Norman Sartorius

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Meltzer, H.Y. (2020). Unmet Needs in Patients with Schizophrenia. In: Pompili, M., McIntyre, R., Fiorillo, A., Sartorius, N. (eds) New Directions in Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-42637-8_2

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  • DOI: https://doi.org/10.1007/978-3-030-42637-8_2

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-42636-1

  • Online ISBN: 978-3-030-42637-8

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