By Sophia Vinogradov, MD
Over the last decade or so, our field has experienced a radical shift in our understanding of schizophrenia and other serious psychotic disorders, such as schizoaffective disorder and bipolar disorder with psychosis. We now understand that these are neurocognitive disorders (ie, how neural systems in the brain represent and process information). We also understand that they are neurodevelopmental disorders with genetic components and antecedents during gestation. The developmental course unfolds with increasing signs, symptoms, and cognitive dysfunction, until the onset of the first episode of psychosis during adolescence or early adulthood. Cognitive deficits are more significant determinants of functional outcome than are symptoms, although most current psychiatric treatments focus only (or mostly) on symptom management.
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