The Epidemiology of Schizophrenia - Hardcover

Hardcover

ISBN 10: 052177540X ISBN 13: 9780521775403

Publisher: Cambridge University Press, 2003

Synopsis

An international team of leading researchers and clinicians provides the first comprehensive, epidemiological overview of this multi-faceted and still-perplexing disorder. Controversial issues such as the validity of discrete or dimensional classifications of schizophrenia and the continuum between psychosis and 'normality' are explored in depth. Separate chapters are devoted to topics of particular relevance to schizophrenia such as suicide, violence and substance abuse. Finally, new prospects for treatment and prevention are considered.

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Reviews

Historically, epidemiologic contributions to research on schizophrenia have involved descriptive studies of the incidence and prevalence of the disease and associated risk factors, as well as longitudinal studies of its course and outcome. The Epidemiology of Schizophrenia, which is a comprehensive review of the subject, adds to this foundation by including chapters on temporal variation, urbanization and migration, prodromal factors, molecular genetics, and prevention. The study of molecular genetics and the prevention of schizophrenia are of particular interest to both researchers and clinicians. Even though it is acknowledged that genetic mechanisms have a prominent role in the cause of schizophrenia, the nature of the genetic transmission remains largely unknown. At one end of a continuum is the possibility that a mutation in a single gene may cause schizophrenia, and at the other end is the prospect that many genes may interact with one another -- and with the patient's environment -- to cause this illness. The rapid pace of recent technological advances in molecular genetics has greatly increased the feasibility of using linkage analysis and association studies to search for potential susceptibility genes. The most important implications of a successful search for a genetic cause of schizophrenia is how this knowledge will influence diagnosis and treatment. Eventually, the discovery of causative genes will almost certainly lead to more accurate diagnoses and more effective treatment. Section III presents the most recent findings on the genetic epidemiology of schizophrenia. Results of classic family studies, high-risk studies, twin studies, and adoption studies are presented in detail by Cardno and Murray in chapter 10. Zammit and colleagues do an excellent job in an overview of the current status of molecular genetics, including linkage studies and association studies. It is widely accepted that there is a gene-environment interaction involved in the causes of schizophrenia. Chapter 12 presents an evidence-based description of the role of environmental factors in the genetic epidemiology of the disease; the models of gene-environment interaction are of special interest. Van Erp and colleagues take the gene-environment interaction to the next level by introducing into it variables associated with neuroimaging. By tying the interaction to the results of brain mapping, the book presents the reader with an opportunity to understand the relation between the structure of the brain and the development of schizophrenia. The most interesting research on schizophrenia today concerns the association among risk factors, prodromal onset, and prevention. Although the concept of a predisposition to schizophrenia has fascinated researchers for close to 100 years, the study of such a predisposition is recent. It is clear from longitudinal studies of persons at high risk, family studies of cognitive function, and studies based on neuroimaging, neurochemistry, psychophysiology, and social functioning that the predisposition to schizophrenia involves more than the clinical symptoms required for a diagnosis of the disorder according to the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Diseases. An understanding of the interactions among many dimensions (e.g., the neuroanatomical, neurochemical, neuroendocrine, and psychophysiological) will provide an increasingly integrated view of the predisposition to schizophrenia. As the identification and validation of prodromal features progress, clearer targets for treatment will become available. As investigators in the field develop interventions to reduce symptoms, the pressure to define a syndrome of predisposition will become more acute. Both of these lines of research will aid the development of interventions to prevent the development of psychosis in those with a predisposition to schizophrenia. Every chapter in this book adds to the base of knowledge needed to develop the tools necessary for the prevention of schizophrenia. The book concludes by mapping the current and future strategies needed for work toward the goal of preventing the disease. I recommend this book highly. All the ingredients required for an understanding of the epidemiology of schizophrenia are between its covers. The editors have made a remarkable effort to organize the material into a consolidated work. Ming T. Tsuang, M.D., Ph.D.
Copyright © 2003 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Edition details

• Publisher: Cambridge University Press
• Publication date: 2003
• Language: English
• ISBN 10: 052177540X
• ISBN 13: 9780521775403
• Binding: Hardcover
• Edition number: 1
• Number of pages: 472
• Editor: Murray Robin M., Jones Peter B., Susser Ezra, Van Os Jim, Cannon Mary