Publisher's Synopsis
In 1990 the World Health Organization rated schizophrenia as one of the ten leading causes of disability which affects almost one percent of the world's population. Thus, almost 50 million people, the equivalent of a larger European nation, are afflicted by this disorder. The human suffering, family tragedies and financial burden represent a tremendous challenge for the scientific community. Emil Kraepelin and Eugene Bleuler, the founding fathers of the schizophrenia or dementia praecox concept, both postulated that this mental disorder originates in the brain - but as Kraepelin stated almost exactly 100 years ago "The causes of dementia praecox are at the present time still wrapped in impenetrable darkness". Although, since then ongoing, accelerating research efforts have resulted in the accumulation of almost fifty thousand scientific articles and hundreds of symposia on the subject, it has still not been possible to penetrate the "darkness" of the pathophysiological mechanisms for these disorders. Even with today's advanced medical care, schizophrenic patients are deprived an objective diagnostic evaluation and the institution of therapeutic modalities with a strictly causal mechanism of action. Thus lifelong suffering continues, although the drug treatments instituted over the past 50 years have contributed to a reduction of some symptoms, of closed wards and compulsory treatment.
Staffan was a somewhat reserved but brilliant boy in his high school years. His Swedish essays were repeatedly read aloud by his language teacher as excellent examples for less talented students. Staffan was also a very witty person. One of his proverbs goes "There are three kinds of people, those who can count and those who cannot". This slightly bizarre joke might in retrospect represent a vague prodrome for his disorder that soon developed with grandiose ideas, delusional symptoms of poisoning and persecution and with auditory hallucinations of commentary type. When Staffan took his life at the age of 24, he had been offered all available treatments with, as he experienced, little help. This type of patient history is heard repeatedly and reflects the situation for many patients with schizophrenia.
According to all current diagnostic schemes schizophrenia is still an exclusively clinical diagnosis based upon the evaluation of reported and observed psychiatric symptoms. There is yet no accepted biological validation of the diagnosis. The challenge is to see schizophrenia not only as a health problem but also a serious mishap of nature allowing us to explore and understand mind/body interactions, and higher mental functions. The hope for further progress relies upon development of a number of different basic and clinical neuroscience areas. Although infection theories have not been written off, schizophrenia is often viewed as a consequence of early trauma or defects in the development or maturation of the brain. Among several postulated causative factors up to 70% of the risk has been attributed to genetic mechanisms. Developments in molecular genetics, brain imaging and psychopharmacology represent important avenues for current research efforts.
