title: A Novel Bio-Psychosocial-Behavioral Treatment Model in Schizophrenia.
abstract: Despite the substantial burden of illness in schizophrenia, there has been a discrepancy between the beneficial effects of an increased use of antipsychotic medications and achieving limited recovery or remission. Because the focus of the most common antipsychotic medications is on dopamine, which is associated with positive symptoms, there is an unmet need for patients with negative symptoms. Since cognitive and negative symptoms rather than positive symptoms are more closely associated with psychosocial impairments in patients with schizophrenia, the non-dopaminergic systems including glutamate and γ-aminobutyric acid (GABA) of the prefrontal cortex should be of concern as well. The balance of excitation and inhibition has been associated with epigenetic modifications and thus can be analyzed in terms of a neurodevelopmental and neural circuitry perspective. Hence, a novel bio-psychosocial-behavioral model for the treatment of schizophrenia is needed to account for the non-dopaminergic systems involved in schizophrenia, rather than dopaminergic mechanisms. This model can be understood from the viewpoint of neurodevelopment and neural circuitry and should include the staging care, personalized care, preventive care, reducing the cognitive deficits, and reducing stigma. Thomas R. Insel proposed this as a goal for schizophrenia treatment to be achieved by 2030.
authors.affiliation: Department of Psychiatry, Korea University College of Medicine, Seoul 02841, Korea. yongku@korea.edu.
authors.forename: Yong-Ku
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Hanyang University Guri Hospital, Guri 11923, Korea. jchoi@hanyang.ac.kr.
authors.forename: Joonho
authors.initials: J
authors.lastname: Choi
authors.affiliation: Department of Psychiatry, Inje University College of Medicine and Haeundae Paik Hospital, Busan 48108, Korea. cogito-ergo-sum@hanmail.net.
authors.forename: Seon-Cheol
authors.initials: SC
authors.lastname: Park
mesh_terms: D000818:Animals; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D001521:Behavior Therapy / Q000379:methods*; D001921:Brain / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D055495:Neurogenesis; D018377:Neurotransmitter Agents / Q000378:metabolism*; D012559:Schizophrenia / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy
chemical_list: D014150:Antipsychotic Agents; D018377:Neurotransmitter Agents
keywords: bio-psychosocial-behavioral; cognitive; model; neural circuitry; neurodevelopment; schizophrenia