Schizophrenia - contemporary approach

Abstract

Schizophrenia is a complex, chronic, heterogeneous psychiatric disorder that affects approximately 1% of the population. It’s characterized by a triad of positive symptoms (delusions, hallucination), negative symptoms (anhedonia, blunted affect), and cognitive deficits (deficits in attention, working memory). This review aims to provide a comprehensive review of recent advances in understanding schizophrenia’s etiology, pathogenesis, and integrated pharmacological and psychosocial strategies in management. A narrative review of literature published in English between 2015-2025 was performed using Google Scholar, PubMed, Medline, and Web of Science, which included meta-analyses, literature synthesis, controlled clinical trials, cross-sectional studies, and case reports, in addition bibliography of the respective primary studies were analyzed as well. Genome-wide association studies established schizophrenia to have a polygenic risk determined by common risk loci, rare copy-number and de novo variants, which interact with environmental factors (prenatal/perinatal stressors, substance abuse), disrupting neurodevelopmental processes, and leading to neurotransmitter and immune dysregulation. Pharmacotherapy has progressed to/second-/third- generation antipsychotics, and emerging drugs beyond dopamine antagonism. Recovery-focused approach combines medication with psychosocial interventions -CBT for psychosis, cognitive remediation, and family psychoeducation- to improve functional recovery. An integrated biopsychosocial model that deals with schizophrenia’s multifactorial and multidimensional nature is necessary. Combining targeted pharmacotherapy and personalized psychosocial interventions offers the best possibilities for symptom improvement, functional recovery, and quality of life.