Schizophrenia today: what do we know-and how sure are we?

The growth of our understanding of the biology and treatment of schizophrenia is still very much a work in progress. In this article, which introduces a series of papers presented at a conference entitled "Schizophrenia: Doing the Right Thing Well," held at Northcoast Behavioral Healthcare System (Cleveland, May 2000), the authors provide a short overview of what is known about schizophrenia today. He briefly reviews findings concerning epidemiology, phenomenology and course, neurobiology, and treatment, and highlights some of the most significant findings to date as well as areas needing further research. Early evaluation and treatment, in advance of the florid presentation of the illness, offer much hope, but only if our knowledge of the diagnostic specificity of prodromal and neurodevelopmental precursors can be enhanced. Significant advances in medication treatment have been made, and the newer antipsychotic medications overall have a more benign adverse-effect profile than the older agents, although the specter of endocrine/metabolic complications looms as a significant long-term concern. The authors conclude that, although many advances in our understanding of the etiology and treatment of schizophrenia have been made, much remains to be learned.