title: Schizophrenia: a systemic disorder.
abstract: The concept of schizophrenia that is most widely taught is that it is a disorder in which psychotic symptoms are the main problem, and a dysregulation of dopamine signaling is the main feature of pathophysiology. However, this concept limits clinical assessment, the treatments offered to patients, research, and the development of therapeutics. A more appropriate conceptual model is that: 1) schizophrenia is not a psychotic disorder, but a disorder of essentially every brain function in which psychosis is present; 2) it is not a brain disease, but a disorder with impairments throughout the body; 3) for many patients, neuropsychiatric problems other than psychosis contribute more to impairment in function and quality of life than does psychosis; and, 4) some conditions that are considered to be comorbid are integral parts of the illness. In conclusion, students, patients, and family members should be taught this model, along with its implications for assessment, research, and therapeutics.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of Nevada, Reno, NV.
authors.forename: Brian
authors.initials: B
authors.lastname: Kirkpatrick
authors.affiliation: Department of Psychiatry and Health Behavior, Georgia Health Sciences University, Augusta, GA.
authors.forename: Brian
authors.initials: B
authors.lastname: Miller
authors.affiliation: Schizophrenia Program, Department of Psychiatry, Neuroscience Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain.
authors.forename: Clemente
authors.initials: C
authors.lastname: García-Rizo
authors.affiliation: Department of Psychiatry, Behavioural and Clinical Neuroscience Institute (BCNI), University of Cambridge, Good Outcome Schizophrenia Clinic, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK, Huntingdon, UK.
authors.forename: Emilio
authors.initials: E
authors.lastname: Fernandez-Egea
mesh_terms: D000818:Animals; D001921:Brain / Q000503:physiopathology; D003072:Cognition Disorders / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D020022:Genetic Predisposition to Disease; D006801:Humans; D008659:Metabolic Diseases / Q000150:complications / Q000378:metabolism / Q000503:physiopathology; D012559:Schizophrenia / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D012565:Schizophrenic Psychology
keywords: Dopamine; Endophenotype; Neurodevelopment; Psychosis; Schizophrenia