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Minerva Psichiatrica 2004 September;45(3):109-14

language: Italian

Present trends in the diagnosis and treatment of schizophrenia

Bogetto F., Rocca P.


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The heterogeneity issue in schizophrenia implies the shift from a categorical view of symptoms to a dimensional one. The use of a multidimensional approach seems to be a promising strategy to better understand the disorder and to better define the diagnosis and treatment. The neurodevelopmental hypothesis is one of the popular theories about the origins of schizophrenia. Neuroimaging studies show structural and functional abnormalities in some cerebral area. This hypothesis is supported by some evidences of neurocognitive deficits in schizophrenic patients. These deficits are considered the core of the disease, and as endophenotypes are useful for the genetic research in schizophrenia. Neurocognitive deficits are strongly correlated with negative symptoms and disorganization, and seem to be associated with early age of onset of schizophrenia, but there is no concordance between studies. Another important issue is the depression in schizophrenia, and its prognostic importance seems to depend by the state of the disease: during the acute phase depression is associated with a positive outcome, while its onset during the chronic phase of the disease seems to be associated with a worse clinic symptomatology and poor outcome. These data have an important clinical impact: the new therapies with new atypical antipsychotics act on different dimensions, with specific treatment strategies in different symptoms of schizophrenia.

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