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Developmental aspects of schizophrenia and related disorders: possible implications for treatment strategies

Eric Davies is Consultant Child and Adolescent Psychiatrist working with the 5 Boroughs Partnership NHS Trust (The Elms, 50 Cowley Hill Lane, St Helens, Merseyside WA10 2AW, UK. Email: eric.davies2{at}5bp.nhs.uk). He trained at the University of Manchester, where he also completed a PhD on factors related to genetic susceptibility in systemic lupus erythematosus. He has a particular interest in the genetics of schizophrenia and is an Honorary Research Fellow in the Division of Psychiatry at the University of Manchester.

Schizophrenia and other schizophrenia-spectrum disorders are neurodevelopmental disorders which may share genetic susceptibility factors and represent differential expressions of an underlying vulnerability. Schizophrenia may have its onset in childhood and can be reliably diagnosed. However, developmental factors modulate disease expression in children. Although the prevalence of schizophrenia in childhood is low, children who develop schizophrenia in adult life may show subtle and non-specific developmental abnormalities, consistent with the neurodevelopmental hypothesis. Studies of the schizophrenia prodrome also demonstrate that abnormalities may be apparent years before the onset of positive symptoms. Such evidence raises the possibility of using preventive approaches in the treatment of schizophrenia. Further advances in our knowledge of the aetiopathology of schizophrenia (and the identification of endophenotypes within the group of schizophrenia and related disorders) may further improve our ability to predict disease development, making implementation of preventive interventions more achievable.