title: Altering the course of schizophrenia: progress and perspectives.
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.
authors.affiliation: Pole for Innovation in Neuropsychiatry, Institut de Recherche (IDR) Servier, 78290 Croissy-sur-Seine, France.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Millan
authors.affiliation: Inserm, U836, Physiopathologie du cytosquelette, Grenoble Institut des Neurosciences, 38700 Grenoble, France.
authors.forename: Annie
authors.initials: A
authors.lastname: Andrieux
authors.affiliation: Department of Psychiatry, The David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California 90095, USA.
authors.forename: George
authors.initials: G
authors.lastname: Bartzokis
authors.affiliation: Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Cadenhead
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
authors.forename: Paola
authors.initials: P
authors.lastname: Dazzan
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
authors.forename: Paolo
authors.initials: P
authors.lastname: Fusar-Poli
authors.affiliation: Psychiatrische Universitätsklinik der Charité im Saint Hedwig-Krankenhaus, 10115 Berlin, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Gallinat
authors.affiliation: Child Psychiatry Branch, Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, California 92093, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Giedd
authors.affiliation: Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois 60612, USA.
authors.forename: Dennis R
authors.initials: DR
authors.lastname: Grayson
authors.affiliation: Freiburg Brain Imaging Center, University of Freiburg, 79106 Freiburg, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Heinrichs
authors.affiliation: Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, 3584 CX Utrecht, Netherlands.
authors.forename: René
authors.initials: R
authors.lastname: Kahn
authors.affiliation: Service de Psychiatrie, Centre Hospitalier Sainte-Anne, 75014 Paris, France.
authors.forename: Marie-Odile
authors.initials: MO
authors.lastname: Krebs
authors.affiliation: Inserm, U955, Psychopathologie et génétique des maladies psychiatriques, 94000 Créteil, Paris, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Leboyer
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.
authors.forename: David
authors.initials: D
authors.lastname: Lewis
authors.affiliation: Medical Research Council (MRC) Centre for Developmental Neurobiology, King's College London, London SE1 1UL, UK.
authors.forename: Oscar
authors.initials: O
authors.lastname: Marin
authors.affiliation: Le Centre National de la Recherche Scientifique (CNRS), UMR-5203, Institut de Génomique Fonctionnelle, F-34000 Montpellier, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Marin
authors.affiliation: Central Institute for Mental Health, Medical Faculty Mannheim, University of Heidelberg, J5, Mannheim, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Meyer-Lindenberg
authors.affiliation: Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, Victoria 3052, Australia.
authors.forename: Patrick
authors.initials: P
authors.lastname: McGorry
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, King's College London, London SE5 8AF UK.
authors.forename: Philip
authors.initials: P
authors.lastname: McGuire
authors.affiliation: Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff CF24 4HQ, UK.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Owen
authors.affiliation: Institute of Neuroscience and Psychology, University of Glasgow, Glasgow G12 8QB, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Patterson
authors.affiliation: Johns Hopkins University Schools of Medicine and Public Health, Baltimore, Maryland MD21205, USA.
authors.forename: Akira
authors.initials: A
authors.lastname: Sawa
authors.affiliation: Spedding Research Solutions SARL, 78110 le Vesinet, France.
authors.forename: Michael
authors.initials: M
authors.lastname: Spedding
authors.affiliation: Institute of Neuroscience and Psychology, University of Glasgow, Glasgow G12 8QB, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Uhlhaas
authors.affiliation: Child Study Center, Yale School of Medicine, New Haven, Connecticut 06519, USA.
authors.forename: Flora
authors.initials: F
authors.lastname: Vaccarino
authors.affiliation: Department of Psychiatry and Behavioural Sciences, University of Miami Miller School of Medicine, Miami 33136, Florida, USA.
authors.forename: Claes
authors.initials: C
authors.lastname: Wahlestedt
authors.affiliation: Lieber Institute for Brain Development, Johns Hopkins University School of Medicine, Baltimore, Maryland MD21205, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Weinberger
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use*; D006801:Humans; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents