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JAMA Insights
December 28, 2020

The Pharmacologic Treatment of Schizophrenia—2021

Author Affiliations
  • 1Nathan Kline Institute for Psychiatric Research, NYU Langone Health, NYU Grossman School of Medicine, New York, New York
  • 2Associate Editor, JAMA
JAMA. 2021;325(2):175-176. doi:10.1001/jama.2020.19048

Schizophrenia is a chronic psychotic disorder with typical onset in early adulthood and a lifetime prevalence of approximately 1%. In addition to the hallmark symptoms of psychosis (delusions, hallucinations, disordered thinking), individuals may experience negative symptoms (apathy, loss of emotional expression) and cognitive deficits. In the past, people with schizophrenia often were confined life-long to psychiatric hospitals; however, the introduction of effective antipsychotic drugs, starting with chlorpromazine (Thorazine) in 1954, followed by the federal Community Mental Health Act of 1963 resulted in deinstitutionalization of an estimated 92% of hospitalized patients by 1994. Although outpatient treatment has been largely successful in allowing people with schizophrenia to live in the community, a shortage of treatment and rehabilitation services and housing, combined with reluctance of some to accept services, has contributed to high rates of homelessness and incarceration among those with schizophrenia in the US.

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