Almost every schizophrenic retreats from society to a mild, moderate, or pronounced degree. The patient seems to live in a shell, or in a world of his own, or behind what has been called an autistic barrier.

The schizophrenic process elicits psychosomatic attempts to integrate the highest cortical functions at a lower level. With comparatively few exceptions this attempt fails because the process engenders other self-perpetuating mechanisms that lead to regressions.

Of all the creative activities of the schizophrenic patient, painting is the one that has been studied the most, and we shall devote the bulk of this chapter to this subject.

Epidemiology is a science and methodology whose object is to determine whether there is an association between a rate of illness and the changing strength of an environmental factor. The characteristics that are studied in relation to the incidence of schizophrenia may be biological, psychological, sociological, or difficult to categorize.

Transcultural psychiatry studies whatever pertains to the field of psychiatry in relation to cultural differences. The variable in these studies is the culture. We can study whether a given culture confers a special type of symptomatology to schizophrenia. We can attempt to determine whether a given culture enhances the occurrence of some syndromes, related to schizophrenia, but not generally included in the schizophrenic category.

We shall now study schizophrenia from the point of view of its progression, meaning progression toward regression.

This chapter discusses primary prevention aimed at lowering the incidence (or making less probable the onset) of psychiatric disorders.

1. Basic prevention, which aims at the elimination of those items that increase potentiality or increase the vulnerability for the disorder.

2. Longitudinal prevention, which aims at assisting the individual throughout his life to avoid those developments that will enhance actualization of schizophrenia.

3. Critical prevention, which aims at avoiding those factors or specific events that will precipitate an attack or onset of schizophrenia.

The second, or advanced, stage of schizophrenia is reached when the symptoms seem crystallized, to have assumed a fixed and definite form.

I gave the name “preterminal” to a stage of schizophrenia that is rather difficult to delimit or to differentiate. This stage occurs generally from five to fifteen years after the beginning of the illness but may occur sooner or later. Particular attention will be given in this chapter to two habits that are the most common—the hoarding and the self-decorating habits.