The psychobiology of first-episode schizophrenia

To examine research and clinical interest in the first episode of schizophrenia. Pathobiological features have been shown to be a consequence of the disorder rather than the effects of chronicity, drug treatment or institutionalization. There is increasing evidence that ventricular enlargement is a robust finding and hypofrontality on PET and SPECT is associated more with symptomatology than with neuroleptic treatment.

Neuroleptic threshold studies suggest that lower daily dosages and onset of medication may be the most important response prediction parameters.

The role of novel antipsychotics in the treatment of first-onset schizophrenia merits investigation for lower rates of extrapyramidal syndromes and tardive dyskinesia. To reduce relapse rates, psychiatrists need to introduce practice standards employing those biopsychological features in the management of first-episode schizophrenia.