Schizophrenia and Other Primary Psychotic Disorders

Schizophrenia is a severe mental illness characterized by psychotic symptoms (especially auditory hallucinations, paranoia, other delusions), negative symptoms (social withdrawal, reduced engagement in activities, flattened affect), disorganized thought process, and cognitive symptoms. The etiologies are not well understood but likely involve genetic risk factors and environmental stressors that combine to cause enduring symptoms. A number of comorbid conditions and adverse events occur at increased rates among persons with schizophrenia, including substance use, depression, suicide, and medical problems. Treatment goals begin with identification and engagement of high-risk individuals, followed by psychotherapy (especially cognitive behavior therapy), early identification of psychotic symptoms, pharmacological treatment with antipsychotic medications, management of co-occurring conditions, and maintaining an optimistic focus on functional recovery.