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Editorial   |    
From the Guest Editor
John Lauriello, M.D.
FOCUS 2004;2:5-5.
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Copyright 2004 American Psychiatric Association

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No other mental illness is associated with as much fear and misunderstanding as schizophrenia. The root schizo in the term has led to its being commonly mistaken for "split personality" or "multiple personality." However, the "schism" refers to that between a person’s thoughts and feelings; thus, for example, an afflicted person may flatly describe some emotionally laden event. I recall interviewing one of my patients with schizophrenia who had recently lost his mother, with whom he had a very close relationship. He recounted the suddenness of her death as if he was telling me some mundane fact. Sitting next to him was his older brother, openly crying over their mother’s death. Of course my patient felt the loss of his mother—and he would subsequently decompensate and require hospitalization—but his affect masked the importance of the event. Maybe "split personality" is not so far afield. Patients with schizophrenia will often say that they are split off from family, society, and their former selves. It is a pervasive disorder that, it could be argued, changes or molds a person’s personality forever.

In this issue we attempt to provide an overview of this devastating illness. In the clinical synthesis article, we offer a framework for evaluating the first presentation of a patient with psychosis, which includes an approach to interviewing the patient and family members, consideration of the various possible causes of psychosis (with schizophrenia as the prototypical cause), and an emphasis on the immediate need to ensure safety and stability for the patient. In the review article, Jibson and colleagues present a comprehensive review of schizophrenia, including its presentation, underlying biological theories, and state-of-the-art psychosocial and pharmacological treatment. We hope that both articles provide experienced clinicians a worthwhile review and clinicians in training some helpful new information. Finally, more than a dozen influential articles on schizophrenia are reprinted in this issue, covering all facets of the disorder and its treatment.




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