精神分裂症的臨床與精神病理

Clinical Aspect and Psychopathology of Schizophrenia

精神分裂症可說是二十世紀以來最為人注意的重大精神疾病，是一個多病因，具高度遺傳性的嚴重疾病，將近一半的精神醫學研究投入這個疾病的研究。一方面因為它通常發病早，病程慢性化，對病人、家屬及社會的影響相當大；另方面它也是複雜精神疾病病理研究的典範。本文回顧其盛行率、預後、病理機轉、治療現況及未來展望，期待未來能結合基因研究、細胞模式、神經組織研究、動物模型及神經影像研究，掌握致病機轉，並找到生物指標，達到早期診治及預防發病的願景。

Schizophrenia has been the most noticeable major mental illness since 20th century. It is a debilitating disorder with heterogeneous manifestations and high genetic hereditability, and with very large amount of research involved. On the one hand, it is an early-onset and chronic illness, with great impact on patients, families and the whole society; on the other, it is also a research paradigm for complex mental disorders. In this article, we review its prevalence, prognosis, psychopathological mechanisms, treatment and future prospect. It is hoped that, by integrating genetic, neuropathological and neuroimaging research, and cellular and animal models, the underlying mechanisms and biological markers of this disorder can be revealed and the goal of early treatment and prevention can be achieved.