Collins E. Lewis
Washington University School of Medicine
St. Louis, Missouri
Schizophrenia is a chronic, severe mental disorder that occurs in about 1% of the population and has equal prevalence in men and women. The etiology of the disorder has not been clearly elucidated; however, genetic factors and early brain injury from prenatal and obstetric complications have been implicated. Hypotheses have been formulated involving dysfunction of the dopamine and glutamate neurotransmitter systems ( 1).
Onset is usually occurs between the late teens and the mid-30s. The illness is characterized by symptoms such as delusions, hallucinations, disorganized speech, disorganized behavior, and negative symptoms (e.g., affective flattening, alogia, and avolition). This symptom picture is accompanied by psychosocial deterioration with marked impairment in employment, interpersonal relations, and self-care. Ideally, the disorder should be diagnosed in the absence of major mood disorders, pervasive developmental disorders, and major contributions from substance use and medical disorders ( 2).
The onset of schizophrenia may be either abrupt or insidious with gradual social withdrawal, loss of interest in school or work,