A Study on Etiological Factors of Schizophrenia

Progress Report Schizophrenia is a chronic and devastating major psychiatric disorder. It costs a lot of the individual patient, the family as well as the society. Schizophrenic patients occupy around 80% of the chronic psychiatric beds. About 60 % of the acute psychiatric beds serve the schizophrenic patients at severe aggravating state of illness. The majority of the schizophrenic patients need the support of the family for their daily life. For better service of these patients, their family as well as for reducing social stigma of schizophrenia patients, more psychopathological understanding is crucial. However, schizophrenia is a complex disorder. For the past one century, the understanding of schizophrenia improved much. In Taiwan, the psychopathological study on schizophrenia deserves basic and systematic approach for clinical and academic purpose.

Before it could be possible to understand the essence of the psychopathology of schizophrenia, the descriptive psychopathology has to be well documented. The heterogeneity at the level of clinical pathology has to be delineated as the initial step of psychopathological study of schizophrenia. This is crucial under the consideration of cross-cultural application of diagnostic criteria in the definition of schizophrenia. The psychopathology of the disease category of schizophrenia as defined by the DSM-IV system was documented mainly by the literature based on the descriptive study of the patients of the Caucasian population and the related culture. Western medicine in Taiwan is totally accepted in the academic circle. From a cross-cultural point of view, this way of academic operation has to be reflected methodologically and to be examined empirically.

Research on schizophrenia psychopathology has to be of two kinds of value. The first is to be of the frontier academic work of the World Psychiatry, and the study results can contribute to the knowledge of the World Psychiatry Literature. The second is to be of native cultural value. The results could be of value in reflecting the native cultural reality and could be of value in application of these study results to clinical service.

To be at the frontier of schizophrenia research, the neuropsychological impairments underlined the clinical manifestations of schizophrenia is one major area of study. In contrast to the traditional theory of psychological defense mechanism or the psychosocial explanation of psychopathology of schizophrenia, the neuropsychological approach could provide the way to understand the neural mechanism of schizophrenia psychopathology at the level of psychological function. In the era of neuroscience achievement, this approach is promising and crucial.

The most basic psychopathology of schizophrenia is the genetic factor of etiology. In the era of molecular medicine, the genetic epidemiological and molecular genetic study on schizophrenia psychopathology is the most frontier line of schizophrenia research.