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Page 1 of 11

  • 9.10 - Schizophrenia

  • from 9 - Integrated Neurobiology of Specific Syndromes and Treatments
  • Edited by Mary-Ellen Lynall, University of Cambridge, Peter B. Jones, University of Cambridge, Stephen M. Stahl, University of California, San Diego
  • Book:
    Cambridge Textbook of Neuroscience for Psychiatrists
    Published online:
    08 November 2023
    Print publication:
    16 November 2023, pp 467-476

  • Summary

    Described over a century ago, schizophrenia still presents personal, clinical and scientific challenges, and is increasingly considered a concept rather than a single disorder. It has become a paradigmatic psychiatric disorder while remaining something of an enigma. Defined by a syndrome of psychotic phenomena (positive phenomena such as delusions, hallucinations or disordered thought structure) and negative features resulting from motivation and emotional dysfunction, schizophrenia is defined by symptoms lasting at least 4 weeks and impairment for 6 months or more [1, 2]. Where the illness is short-lived, the clinical syndrome is defined as a schizophrenia-related diagnosis [1]. The clinical presentation usually encompasses features prominent in other psychiatric conditions such as cognitive dysfunction, motor abnormalities, obsessional phenomena or depression. These additional features not included in the definition of schizophrenia underscore its pervasive neural dysfunction; they influence management and often shape the clinical outcome. The seeds of schizophrenia may be sown in early life with aberrant childhood development in multiple domains [2], but the clinical syndrome typically presents in early adulthood (Figure 9.10.1); abnormal neural connectivity may underly these seemingly remote phenomena.

  • Introduction

  • Edited by Mary-Ellen Lynall, University of Cambridge, Peter B. Jones, University of Cambridge, Stephen M. Stahl, University of California, San Diego
  • Book:
    Cambridge Textbook of Neuroscience for Psychiatrists
    Published online:
    08 November 2023
    Print publication:
    16 November 2023, pp 1-3

  • Summary

    In the past 100 years, there has been a revolution in our understanding of the brain. So far, this has done little to disrupt mainstream psychiatric practice. That is set to change. New neuroscience-based treatments are emerging, while evidence from neuroscience and genetics are calling into question traditional diagnostic boundaries. Psychiatrists of the future will need to integrate their understanding of brain imaging, molecular diagnostics, psychological factors and social context to provide neuroscience-informed care plans.

Cambridge Textbook of Neuroscience for Psychiatrists
  • Edited by Mary-Ellen Lynall, Peter B. Jones, Stephen M. Stahl
  • Published online:
    08 November 2023
    Print publication:
    16 November 2023
  • Cambridge Textbook of Neuroscience for Psychiatrists is a 'one stop shop' for what any psychiatrist needs to know about the brain. Understanding the brain and mind requires a vast array of techniques and conceptual approaches. The Editors have assembled a team of basic neuroscientists, geneticists, psychologists, psychiatrists, neurologists, neurosurgeons and endocrinologists who bring you the cutting edge of translational neuroscience that addresses the material most relevant to current or future psychiatric practice. The book showcases what is known, highlights aspects that are less well understood and defines key outstanding questions. A revolution in our understanding of the brain has, so far, done little to disrupt mainstream psychiatric practice. That is set to change. The chapters align with the UK MRCPsych neuroscience syllabus and link to the USA National Neuroscience Curriculum Initiative (NNCI). Highly illustrated and accessible, this book will appeal to psychiatrists, neuroscientists, psychologists, other healthcare students and professionals.

Cambridge Prescriber's Guide in Psychiatry
  • Edited by Sepehr Hafizi, Peter B. Jones, Stephen M. Stahl
  • Edited in association with Veronika Dobler, Liliana Galindo, George Griffiths, Neil Hunt, Mohammad Malkera, Asha Praseedom, Pranathi Ramachandra, Judy Rubinsztein, Shamim Ruhi
  • Coming soon
  • Expected online publication date:
    October 2023
    Print publication:
    16 November 2023
  • Based on the best-selling Stahl's Prescriber's Guide, this essential guide to psychiatric prescribing has been developed by leading psychiatrists and medical students from the University of Cambridge to support all mental health professionals in achieving optimal care for their patients. Written with the authority of evidence and the guidance of clinical wisdom the formulary covers the psychotropic medications used in daily care including dosing recommendations and drug interactions. With its easy-to-use, full-colour template-driven navigation system, the book combines evidence-based data with clinically informed advice, including guidance on prescribing for children and adolescents and people with addictions. Drugs are presented in the same format to facilitate rapid access to information and are broken down into sections designated by a unique colour background thereby clearly distinguishing information presented on therapeutics, side effects, dosing and use, and the art of psychopharmacology. Popular prescribing 'tips and pearls are included throughout.

  • Resilient functioning is associated with altered structural brain network topology in adolescents exposed to childhood adversity

  • Nadia González-García, Elizabeth E.L. Buimer, Laura Moreno-López, Samantha N. Sallie, František Váša, Sol Lim, Rafael Romero-Garcia, Maximilian Scheuplein, Kirstie J. Whitaker, Peter B. Jones, Raymond J. Dolan, NSPN consortium, Peter Fonagy, Ian Goodyer, Edward T. Bullmore, Anne-Laura van Harmelen
  • Journal:
    Development and Psychopathology , First View
    Published online by Cambridge University Press:
    26 July 2023, pp. 1-11
    • Article
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  • Childhood adversity is one of the strongest predictors of adolescent mental illness. Therefore, it is critical that the mechanisms that aid resilient functioning in individuals exposed to childhood adversity are better understood. Here, we examined whether resilient functioning was related to structural brain network topology. We quantified resilient functioning at the individual level as psychosocial functioning adjusted for the severity of childhood adversity in a large sample of adolescents (N = 2406, aged 14–24). Next, we examined nodal degree (the number of connections that brain regions have in a network) using brain-wide cortical thickness measures in a representative subset (N = 275) using a sliding window approach. We found that higher resilient functioning was associated with lower nodal degree of multiple regions including the dorsolateral prefrontal cortex, the medial prefrontal cortex, and the posterior superior temporal sulcus (z > 1.645). During adolescence, decreases in nodal degree are thought to reflect a normative developmental process that is part of the extensive remodeling of structural brain network topology. Prior findings in this sample showed that decreased nodal degree was associated with age, as such our findings of negative associations between nodal degree and resilient functioning may therefore potentially resemble a more mature structural network configuration in individuals with higher resilient functioning.

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