John Lauriello, William P. Horan, * and Juan Bustillo
University of New Mexico
Albuquerque, New Mexico
Schizophrenia is a chronic mental illness that has a severe impact on patients and those who are close to them. Kraepelin's classic description of schizophrenia (“dementia praecox”) as a unitary degenerative disease that inevitably results in a grossly deteriorated end state has been refuted on empirical grounds, with contemporary research supporting a more optimistic prognostic picture. However, schizophrenia is a disorder that persists across the lifespan at varying degrees of severity and requires a multifaceted, long-term treatment approach as the needs of patients change over time. To optimally treat patients with schizophrenia, the unique issues that emerge during each patient's progression through the different stages of life must be addressed.
Several factors about schizophrenia must be acknowledged at the outset in describing phases of illness and their accompanying implications for treatment. First, schizophrenia is a heterogeneous clinical syndrome with a course that is characterized by considerable inter- and intraindividual variability. Second, data regarding the natural history of schizophrenia are scarce and rarely prospective, which considerably
*Current affiliation: Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.