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Schizophrenia.(EBMH Notebook)
The EBMH Notebook summarises key messages about schizophrenia, sourced from: Clin Evid Concise 2003;10:235-7. For this review, Clinical Evidence Concise searched and appraised material published until December 2002.
DEFINITION
Schizophrenia is characterised by the positive symptoms of auditory hallucinations, delusions, and thought disorder, and by the negative symptoms of demotivation, self neglect, and reduced emotion. (1) People are defined as being resistant to standard antipsychotic drugs if, over the preceding 5 years, they have not had a clinically important improvement in symptoms after 2-3 regimens of treatment with standard antipsychotic drugs for at least 6 weeks (from at least 2 classes at doses equivalent to or greater than 1000 mg/day chlorpromazine) and they have had no period of good functioning. (2 3) Approximately 30% (10-45%) of people with schizophrenia meet these criteria. (3)
INCIDENCE/PREVALENCE
Onset of symptoms typically occurs in early adult life (average age 25 years) and is earlier in men than women. (4 5) Prevalence worldwide is 2-4/1000. One in 100 people will develop schizophrenia in their lifetime.
AETIOLOGY/RISK FACTORS
Risk factors include a family history (although no major genes have been identified); obstetric complications; developmental difficulties; central nervous system infections in childhood; cannabis use; and acute life events. (4) The precise contributions of these factors and ways in which they may interact are unclear.
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