Schizophrenia is a psychiatric disorder with a global prevalence of 1%. Due to abnormal brain development, symptoms most often manifest in early adulthood and progress throughout an individual’s life. The symptoms are divided into perceptual, behavioral, and cognitive disturbances. Schizophrenia patients suffer from breaks with reality, experiencing hallucinations, delusions, paranoia, isolation, and disorganized speech and thinking processes.
As symptoms often manifest during the most productive and formative years of life, few patients are able to sustain educational goals or reach social and occupational milestones.
While the exact cause of schizophrenia is unknown, it is thought that the disorder is heterogeneous, with many different potential causes resulting in a similar picture. Studies suggest that genetic factors, early environment, neurobiology, and psychological and social processes are important contributory factors. Biological studies have validated the diagnosis, including abnormal brain imaging, increased dopamine activity in the mesolimbic pathway and decreased glutamate activity in prefrontal cortical regions, and abnormal EEG and evoked potential findings.
While the diagnosis is based on clinical observations and interviews with the patient, post-mortem studies have confirmed consistent brain pathology in schizophrenia patients.
Critical Unmet Medical Needs in Schizophrenia
- Approximately 2.4 million American adults have schizophrenia (1.1% of US population ages 18 and older)
- In 2002, a study was published in the Journal of Clinical Psychiatry called “The Economic Burden of Schizophrenia in the United States”
- The overall US 2002 cost of schizophrenia was estimated to be $62.7 billion
- Of that, $22.7 billion was excess direct healthcare cost ($7.0 billion outpatient, $5.0 billion drugs, $2.8 billion inpatient, $8.0 billion long-term care), $7.6 billion was direct non healthcare excess costs and $32.4 billion was total indirect excess costs
- These costs do not capture the lost opportunity that patients with schizophrenia experience as the disease typically is diagnosed in young adults
Lack of Treatment Options
Patients, their families, and physicians are in urgent need of additional treatment options for schizophrenia. The first line of treatment for schizophrenia is antipsychotic medication; while these products address “positive” symptoms of the disease (including agitation, hallucinations, and paranoia), currently available antipsychotics have not been shown effective against the residual symptoms of schizophrenia, including “negative” and “cognitive” symptoms of the disease.
- “Negative” symptoms are defined by those functions that are diminished or decreased compared with normal function—loss of interest in everyday activities, lack of emotional relatedness and connection to others, apathy, social withdrawal, loss of motivation, and decreased speech. These symptoms may be persistent and predominate over the positive symptoms in many cases
- “Cognitive” symptoms involve problems with thought processes and the organization of thought. These symptoms often interfere with the ability to perform routine daily tasks. Problems in attention, short- and long-term memory, executive function, and the ability to learn and to process information all compromise schizophrenia patients’ abilities to function in society, achieve personal goals, and comply with medication regimens
Today, it is evident that cognitive impairment in schizophrenia is a fundamental and defining feature of the disorder, and interest in these cognitive deficits has expanded dramatically.
Because of the clear role of cognitive impairment in limiting patient functioning, the development of novel therapies to improve cognitive impairment in schizophrenia is one of today’s most pressing pharmacologic pursuits.
Learn more about how cognitive impairment in schizophrenia can impact patient function.