%0 Journal Article
%T The Concept of Schizophrenia: From Unity to Diversity
%A Heinz H£¿fner
%J Advances in Psychiatry
%D 2014
%R 10.1155/2014/929434
%X After over 100 years of research without clarifying the aetiology of schizophrenia, a look at the current state of knowledge in epidemiology, genetics, precursors, psychopathology, and outcome seems worthwhile. The disease concept, created by Kraepelin and modified by Bleuler, has a varied history. Today, schizophrenia is considered a polygenic disorder with onset in early adulthood, characterized by irregular psychotic episodes and functional impairment, but incident cases occur at all ages with marked differences in symptoms and social outcome. Men¡¯s and women¡¯s lifetime risk is nearly the same. At young age, women fall ill a few years later and less severely than men, men more rarely and less severely later in life. The underlying protective effect of oestrogen is antagonized by genetic load. The illness course is heterogeneous and depressive mood the most frequent symptom. Depression and schizophrenia are functionally associated, and affective and nonaffective psychoses do not split neatly. Most social consequences occur at the prodromal stage. Neither schizophrenia as such nor its main symptom dimensions regularly show pronounced deterioration over time. Schizophrenia is neither a residual state of a neurodevelopmental disorder nor a progressing neurodegenerative process. It reflects multifactorial CNS instability, which leads to cognitive deficits and symptom exacerbations. 1. Introduction For more than a century, there has been research into the question of what schizophrenia really is. We have developed an array of fascinating new research techniques and amassed a wealth of detailed knowledge, but we are still lacking a comprehensive answer to that question. Since its early days, the disease concept of schizophrenia [1, 2] has undergone several modifications. The aim of the present article is to describe, in broad sketches, how the understanding of the disorder has evolved to what it is now. Comparable reviews have appeared in great numbers before, for example, by Tsuang and Faraone [3], Weinberger and Harrison [4], Andreasen [5] and the series of articles published on the occasion of the founding and the 10th and the 20th anniversaries of the journal ¡°Schizophrenia Research.¡± The first of the latter articles, authored by the journal¡¯s cofounder Wyatt together with Alexander, Egan, and Kirch, was entitled ¡°Schizophrenia, Just the Facts¡± and appeared in 1988 [6]. Further articles carrying that title were to follow [7¨C11], until the series finally closed with the conclusion ¡°The current construct¡­is in need of reconceptualization¡± [12]. The
%U http://www.hindawi.com/journals/apsy/2014/929434/