Harvard Mental Health Letter

Challenges in preventing schizophrenia

A major hurdle is identifying those at risk for developing psychosis in the future.

One of the reasons schizophrenia is so disabling is that obvious psychotic symptoms — which are what usually prompt treatment — occur relatively late in the disease process. By then, cognitive function, as measured by various neuropsychological tests, is already lower on average than in healthy individuals.

Neuroimaging studies have revealed that patients in this earlier "prodromal" phase have lost gray matter (neurons and other brain cells) when compared with controls — indicating that some underlying brain damage has occurred. And a preliminary study suggests that patterns of brain activation are already abnormal in those who may be at risk.

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