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Nat Rev Drug Discov. 2016 Jul;15(7):485-515. doi: 10.1038/nrd.2016.28. Epub 2016 Mar 4.

Altering the course of schizophrenia: progress and perspectives.

Author information

1
Pole for Innovation in Neuropsychiatry, Institut de Recherche (IDR) Servier, 78290 Croissy-sur-Seine, France.
2
Inserm, U836, Physiopathologie du cytosquelette, Grenoble Institut des Neurosciences, 38700 Grenoble, France.
3
Department of Psychiatry, The David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California 90095, USA.
4
Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, USA.
5
Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
6
Psychiatrische Universitätsklinik der Charité im Saint Hedwig-Krankenhaus, 10115 Berlin, Germany.
7
Child Psychiatry Branch, Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, USA.
8
Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois 60612, USA.
9
Freiburg Brain Imaging Center, University of Freiburg, 79106 Freiburg, Germany.
10
Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, 3584 CX Utrecht, Netherlands.
11
Service de Psychiatrie, Centre Hospitalier Sainte-Anne, 75014 Paris, France.
12
Inserm, U955, Psychopathologie et génétique des maladies psychiatriques, 94000 Créteil, Paris, France.
13
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
14
Medical Research Council (MRC) Centre for Developmental Neurobiology, King's College London, London SE1 1UL, UK.
15
Le Centre National de la Recherche Scientifique (CNRS), UMR-5203, Institut de Génomique Fonctionnelle, F-34000 Montpellier, France.
16
Central Institute for Mental Health, Medical Faculty Mannheim, University of Heidelberg, J5, Mannheim, Germany.
17
Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Victoria 3052, Australia.
18
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London SE5 8AF UK.
19
Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff CF24 4HQ, UK.
20
Institute of Neuroscience and Psychology, University of Glasgow, Glasgow G12 8QB, UK.
21
Johns Hopkins University Schools of Medicine and Public Health, Baltimore, Maryland MD21205, USA.
22
Spedding Research Solutions SARL, 78110 le Vesinet, France.
23
Child Study Center, Yale School of Medicine, New Haven, Connecticut 06519, USA.
24
Department of Psychiatry and Behavioural Sciences, University of Miami Miller School of Medicine, Miami 33136, Florida, USA.
25
Lieber Institute for Brain Development, Johns Hopkins University School of Medicine, Baltimore, Maryland MD21205, USA.

Abstract

Despite a lack of recent progress in the treatment of schizophrenia, our understanding of its genetic and environmental causes has considerably improved, and their relationship to aberrant patterns of neurodevelopment has become clearer. This raises the possibility that 'disease-modifying' strategies could alter the course to - and of - this debilitating disorder, rather than simply alleviating symptoms. A promising window for course-altering intervention is around the time of the first episode of psychosis, especially in young people at risk of transition to schizophrenia. Indeed, studies performed in both individuals at risk of developing schizophrenia and rodent models for schizophrenia suggest that pre-diagnostic pharmacotherapy and psychosocial or cognitive-behavioural interventions can delay or moderate the emergence of psychosis. Of particular interest are 'hybrid' strategies that both relieve presenting symptoms and reduce the risk of transition to schizophrenia or another psychiatric disorder. This Review aims to provide a broad-based consideration of the challenges and opportunities inherent in efforts to alter the course of schizophrenia.

PMID:
26939910
DOI:
10.1038/nrd.2016.28
[Indexed for MEDLINE]

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