The pathogenesis and management of schizophrenia

Schizophrenia remains a relatively common debilitating and stigmatising disorder, whose precise aetiology is unknown. Research has consistently shown a strong genetic component, although environmental factors are also implicated. A number of biochemical aetiological theories have been proposed but the most plausible is the dopamine hypothesis. This suggests that there is excess activity at central dopaminergic pathways in the brain. Certainly, all effective antipsychotic drugs have dopamine blocking properties. Management of this disorder includes admitting new cases to hospital for careful evaluation by a multidisciplinary team. Although the mainstay of treatment is antipsychotic (neuroleptic) medication, social interventions are also required. These include close liaison with the patient's family, which can help to prevent relapse and aid compliance with drug treatment. Modern therapy aims for recovery of social and occupational skills and gradual rehabilitation back into the community.