Improving the prognosis for schizophrenic disorders

Throughout the world, scientists are attempting to recognize and treat schizophrenic disorders at an earlier stage. It is hoped that this will improve the prognosis, which has often been unfavorable.

In the latest edition of Deutsches Ärzteblatt International (PDF: Dtsch Arztebl Int 2008; 105[30]: 532-9), Joachim Klosterkötter of the Department of Psychiatry and Psychotherapy at Cologne University describes the current state of research into the prevention of schizophrenic disorders and explains how the individual risk of the disease can be assessed and the threat of the initial episode of schizophrenia can be avoided.

Schizophrenic disorders cause a great deal of suffering and greatly impair the patient's quality of life. For example, delusions and acoustic hallucinations are often highly dramatic and frightening. During the course of the disease, thought, feeling, actions, and the ability to make social contacts become impoverished. This can result in psychosocial handicap, even at an early age, with inability to work. The community must pay for medical care and economic losses, corresponding to as much as about 10 billion euros per year. There has normally been an average interval of more than a year between the onset of psychotic symptoms and the initiation of adequate treatment. Centers for the early recognition of schizophrenic disorders have been founded throughout the world in recent years and these centers have been developing new approaches. As Klosterkötter shows, there may soon be prophylactic treatments for every patient with early warning signs of schizophrenia who seeks advice. These treatments would be individualized and would have beneficial effects on the clinical course.