Neurobiology and the natural history of schizophrenia.

Schizophrenia follows a fairly consistent natural history and longitudinal course of illness, and it can be described in the context of four specific clinical stages-the premorbid, prodromal, deterioration, and chronic/residual stages. Many patients treated in their first episode of schizophrenia respond well to treatment and achieve some symptom remission and level of recovery, but recurrent episodes, often brought on by treatment nonadherence or insufficient treatment, lead to more substantial and lasting neurologic deterioration. This presentation describes the clinical stages of schizophrenia and discusses the possibility for prevention of clinical deterioration with early detection and treatment of the illness and sustained maintenance treatment after episodic remission.