INFORMACIONES PSIQUIÁTRICAS 247

84 Informaciones Psiquiátricas 2022 - n.º 247 FIDMAG informa Abstract Schizophrenia, characterised by psychotic symptoms and in many cases social and occupational decline, remains an aetiological and therapeutic challenge. Contrary to popular belief, the disorder is modestly more common in men than in women. A division of symp- toms into positive, negative, and disorganisation syndromes is supported by factor analysis. Catatonic symptoms are not specific to schizophrenia and so-called first rank symptoms are no longer considered diagnostically important. Cognitive impairment is now recognised as a further clinical feature of the disorder. Lateral ven- tricular enlargement and brain volume reductions of around 2% are established findings. Brain functional changes occur in different subregions of the frontal cortex and might ultimately be unders- tandable in terms of disturbed interaction among large-scale bra- in networks. Neurochemical disturbance, involving dopamine and glutamate functions, is supported by indirect and direct evidence. The genetic contribution to schizophrenia is now recognised to be largely polygenic. Birth and early life factors also have an impor- tant aetiological role. The mainstay of treatment remains dopamine receptor-blocking drugs; a psychological intervention, cognitive be- havioural therapy, has relatively small effects on symptoms. Other areas of debate include cannabis and childhood adversity as causa- tive factors, whether there is progressive brain change after onset, and the long-term success of early intervention initiatives. Keywords: schizophrenia, symptoms, causes, treatments, future.