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24 - Developmental models and hypothesis-driven early interventions in schizophrenia

Published online by Cambridge University Press:  04 August 2010

By
Matcheri S. Keshavan  and
Barbara A. Cornblatt
Edited by
Matcheri S. Keshavan ,
James L. Kennedy  and
Robin M. Murray
Matcheri S. Keshavan
Affiliation:
University of Pittsburgh School of Medicine, Pittsburgh and Wayne State University School of Medicine, Detroit, USA
Barbara A. Cornblatt
Affiliation:
Recognition and Prevention Program, Lake Success, New York, USA
Matcheri S. Keshavan
Affiliation:
University of Pittsburgh
James L. Kennedy
Affiliation:
Clarke Institute of Psychiatry, Toronto
Robin M. Murray
Affiliation:
Institute of Psychiatry, London
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Summary

During recent years, three types of pathophysiological models have been proposed, those that posit altered pre- or perinatal brain development, those proposing peri-adolescent developmental abnormalities, and those that argue for neuronal degenerative processes after illness onset. This chapter reviews the lines of evidence from clinical observations and neurobiological research leading to the three seemingly conflicting models. It outlines an alternative model that potentially integrates all three. The chapter discusses the possible remediative and preventive treatment options suggested by the current pathophysiological models. It reviews the data that have emerged from the prevention programs generated by these models. The chapter is concluded by describing the way in which the unifying model newly proposed provides an integrated theoretical foundation for prevention and early intervention in schizophrenia. Evidence-based demonstration of cost effectiveness of such interventions is critically needed if this field of research is to sustain and solidify this paradigm shift.

Keywords

neurobiological researchneurodegenerative modelpathophysiological modelsschizophreniaperi-adolescent developmental abnormalities
Type
Chapter
Information
Neurodevelopment and Schizophrenia , pp. 455 - 472
Publisher: Cambridge University Press
Print publication year: 2004

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