On the trail of schizophrenia

Scientists are tracing its roots in the genome and the brain.

Schizophrenia has presented a puzzle to psychiatry for more than a century, but it's possible that the pieces are beginning to fall into place. The most dramatic symptom of this devastating mental illness is psychosis — hallucinations, delusions, and grossly illogical thoughts, speech, and behavior. More pervasive and at least as important are the negative symptoms — emotional constriction, loss of spontaneity and initiative, seeming lack of interest in life or capacity for pleasure. And researchers are increasingly interested in a variety of cognitive deficiencies, sometimes subtle, that make perceiving the world accurately, thinking, planning, and acting rationally a challenge even for people with schizophrenia who are not in a psychotic state.

Most specialists believe schizophrenia is a developmental disorder that originates before birth and involves circuits in several regions of the brain. Through autopsies, molecular genetic studies, and technology that permits pictures of the living brain both at rest and in action, scientists are beginning to find out what has gone awry and why. They hope to target treatments to specific symptoms and genetic peculiarities, and ultimately to detect the disease at an early stage and maybe, some day, prevent it.

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