Editorial

The present supplement to Pharmacopsychiatry comprises the papers of a Research Workshop on Relapse Mechanisms and Prophylactic Principles in Schizophrenia and Affective Disorders held at Bensberg Castle, Bensberg, Germany, September 18-19, 2003. The aim of the workshop was to bring together German researchers who are working in the field of schizophrenia and affective disorders to discuss concepts of course and outcome as well as treatment principles.

Since the time of Griesinger, illness course has been understood as an empirical characteristic contributing to nosology. The concept of course and outcome in schizophrenia and affective disorders has to accommodate many complexities - on a still narrow knowledge base. The course of these disorders is in general of a recurring nature - with a number of similarities and differences in clinical symptomatology and course typology. Most important is still the difference in their long-term prognosis - ranging from dementia praecox, schizophrenia and schizoaffective disorder to manic-depressive illness. Studying the course in schizophrenia or affective disorders can not only help to inform diagnostic practice, but also to develop and revise etiopathogenetic or prognostic models, thereby illuminating individual, environmental, illness, and treatment contributions to outcome in schizophrenia.

Accordingly, in an introductory session general concepts were discussed. There is a long clinical tradition in conceptualizing course and outcome in the schizophrenias as well as in affective disorders. However, these concepts, definitions and operationalizations had to be reassessed from a modern viewpoint of course typologies, treatment principles and research concepts (Gaebel, Düsseldorf). In the same realm mathematical-statistical concepts and methods as tools for modeling and prediction of illness course had to be revisited (Köpcke, Münster). As an example for etiopathogenetic models current concepts on schizophrenia were selected (Kornhuber, Erlangen). Basic pharmacological principles in long-term treatment and relapse prevention were discussed giving an overview on prophylactic treatment mechanisms (Müller, Frankfurt). Finally, as an analogy for psychiatry, concepts from neurology on relapsing diseases, such as multiple sclerosis and epilepsy, were assessed (Seitz, Düsseldorf).

The main part of the workshop was concerned with schizophrenia and the affective disorders. Concept and long-term treatment of schizophrenic psychoses (Möller, München), etiopathogenetic mechanisms in long-term course of schizophrenia (Falkai, Homburg) and mechanisms of relapse prevention in schizophrenia (Müller, München) are the respective papers on schizophrenia. The topics dealing with basic principles regarding clinical course, long-term therapeutic and prophylactic strategies (Marneros, Halle), the meaning of basic pathophysiological mechanisms in depression and how they affect the course of the illness (Henn, Mannheim) and the mechanisms of action in the prevention of recurrent mood disorders (Baumann, Magdeburg) belong to affective disorders.

The workshop and the present publication have been made possible by a grant from GlaxoSmith Kline. My thanks go to them, and especially to M. Keil, Dr. D. Hütten and D. Krause who also helped in organizing the workshop and in making it a success. I want to thank all the contributors who were actively engaged in this prestigious meeting. I finally want to thank Prof. Dr. W. Müller (Frankfurt), the editor of Pharmacopsychiatry, for his acceptance and advice in preparing this publication.