Schizophrenia: An Enigma That Has Remained Over Several Centuries!
EmPower Research
January 15, 2008
By, Shilpa C Nangali
Schizophrenia has remained a mystery over centuries and its exact causes are still not very clear, despite decades of rigorous research. Having a biological basis, its manifestations are largely behavioral, with wide social ramifications. The issue of stigma and social isolation makes it even more difficult to provide effective care to those battling against it. Scientists have not yet understood all the factors causing schizophrenia, but all the tools of modern biomedical research are being used to search for genes, critical moments in brain development, and other causes that may lead to the illness.
The possible causes of schizophrenia are:
Genetics
It has been known for long that schizophrenia runs in families. People who are closely related to schizophrenic patients are more likely to develop the disorder than people who have no such incidence. Twins, family and adoptions studies suggest that genetic factors play an important role in the development of schizophrenia. The child of a parent with schizophrenia has about 10 per cent chance of developing schizophrenia; and if both parents are schizophrenics, the risk is increases by 40 percent. If an identical twin has schizophrenia, the risk for the other twin (who has the exact same genes as his/her sibling) is about 50 percent. The chances of developing schizophrenia during their lifetime are 14 percent in case of a fraternal twin. By comparison, the risk of schizophrenia in the general population is about one per cent.
Environment
Possible environmental factors include obstetric complications like exposure to influenza during pregnancy and or nutritional deprivation during pregnancy. It has also been suggested that stress and trauma can lead to the emergence of schizophrenia. New studies show that the innate potential of human nature becomes a reality only when exposed to a certain kind of nurture or environment. Some genes are switched on when a person is exposed to a specific environment such as family stress, conflicts, anger and growing up in an emotionally-charged environment, which impact and damage children's brains. This results in the short form of the 5-HTT gene becoming associated with depression and suicide. Studies that support this new view of how environment combines to influence brain development are increasing rapidly. Research has also shown that the smaller the proportion of an ethnic minority the greater the risk of developing this illness.
´Neuro-developmental´ factors
Research in this area investigates the possibility that individuals who develop schizophrenia in early adult life have suffered some from of cerebral ´maldevelopment in utero´. Prenatal difficulties like intrauterine starvation or viral infections, and various nonspecific stressors, seem to influence the development of schizophrenia. It may also be a developmental disorder resulting when neurons in the brain form the wrong connections during fetal development and these errors may not be noticed until puberty There is a great deal of research being carried out in this area. It appears likely that multiple genes are involved in creating a predisposition to develop this disorder. However, it is not yet understood how the genetic tendency is transmitted, and it cannot yet be accurately predicted if a given person will or will not develop the disorder.
Complications during pregnancy, abnormal fetal growth and complications during delivery are significant risk factors in the development of schizophrenia. These play a significant role in the development of schizophrenia along with these main factors:
(a) Bleeding, diabetes and ´pre-eclampsia´ pregnancy complications
(b) Abnormal fetal growth and development problems including conditions of low birth weight and reduced head circumference
(c) Complications of delivery including asphyxia and emergency
Caesarean delivery
However, the effect of such complications is small in comparison with factors like genetic pre-disposition to schizophrenia.
Several regions of the human genome are being investigated to identify genes that may confer susceptibility to schizophrenia. The strongest evidence but not yet confirmed leads to chromosomes 13 and 6. The anatomical abnormalities found in different parts of the brain tend to correlate with schizophrenia´s positive symptoms and negative symptoms. Many studies of people with schizophrenia have found abnormalities in their brain structure or in the way it functions. It should be emphasized that these abnormalities are subtle and are not characteristic of all people with schizophrenia, nor do they occur only in individuals with this illness.
Studies of brain tissue have also shown small changes in number of brain cells or how they are distributed in people with schizophrenia. It appears that many of these changes are present before an individual becomes ill, and schizophrenia may be in part, a disorder in the development of the brain.
In recent years, there has been growing evidence supporting the role of viral infections including the poliovirus, the flu virus and a virus called ´encephalitis lethargica´ in the development of schizophrenia. Few studies have also shown that the increased risk of schizophrenia appears linked to maternal infections during the first and second trimesters of pregnancy especially flu infections. Since the flu season peaks during the fall, it might explain why babies born in the winter and spring have a higher risk. The research is both exciting and troubling. It suggests that the origins of schizophrenia might start early in the womb. Moreover, symptoms of schizophrenia, which typically emerge in late adolescence or early adulthood affecting about 1 percent of the population, may only be the last stage in a long process. Research into the links between maternal flu and schizophrenia is still considered preliminary, which makes any policy conclusions premature, but scientists studying the connection are starting to worry.
Drug misuse
Although contentious, some research also suggests that substance misuse is related to the development of schizophrenia. It is likely that substance misuse may precipitate or worsen the symptoms and interfere in the treatment of a person with schizophrenia. A recent study has indicated that people who had multiple copies of a version of the COMT gene and who smoked marijuana had a 1,000% increase in their risk of developing schizophrenia. This research may partly explain the increased risk of developing schizophrenia for people who smoke marijuana.
Biochemical factors
Certain biochemical imbalances in the brain are believed to be involved in the cause of schizophrenia. Neurotransmitters have long been thought to be involved in the development of schizophrenia. Although there is no definitive answer yet, this is a very active area of schizophrenia research. Excessive levels of the neurotransmitter dopamine have long been implicated in schizophrenia, but it is not yet clear if the excess is a primary cause of schizophrenia or a result of a more fundamental dysfunction. More recent evidence implicates much greater complexity in the ´dysregulation´ of dopamine and other neurotransmitter systems . Some of this research ties schizophrenia to certain variations in dopamine receptors, while other research focuses on the serotonin system. However, it must also be emphasized that in many cases perturbations in neurotransmitter systems may result from complications of schizophrenia, or its treatment, rather than from its causes.
Schizophrenia being a disorder that commonly befalls younger patients, better-informed people would not only have a better understanding for people with schizophrenia, but also a higher likelihood of detecting this disorder in early stages in their peers, thereby indirectly helping to improve overall outcomes.
The outlook for people with schizophrenia has improved over the last 30 years or so. Although there still is no cure, effective treatments have been developed, and many people with schizophrenia are able to lead independent, satisfying lives. This is an exciting time for schizophrenia research. The explosion of knowledge in genetics, neuroscience, and behavioral research will enable a better understanding of the causes of the disorder, how to prevent it, and how to develop better treatments to allow those with schizophrenia to achieve their full potential.
People with a mental illness who are pressured and criticized usually regress and their symptoms worsen. Motivating them is the best way to help them move forward. Going along with the delusions will not be helpful for their growth. It is best to clear to them that they see things differently than the others do and acknowledge that everybody has the right to see things in his or her own perspective. Being respectful, supportive, and kind without tolerating dangerous or inappropriate behavior is the most supportive way to approach people with this disorder.
I would like to conclude by quoting the lines of Pamela S. Wagner, a prize winning poet and journalist, who was also diagnosed with schizophrenia: "I live in a closet (schizophrenia). Unlike most closets, mine is invisible. No one else can see it or touch it or even come inside to keep me company. Nevertheless, its imprisoning walls and terrifying darkness are very real!"
Credits
Books:
Surviving Schizophrenia by Fuller Torrey
Is There No Place on Earth for Me? by Susan Sheehan
Web sites:
http://www.wrongdiagnosis.com/s/schizophrenia/causes.htm
www.schizophrenia.com
www.healthyplace.com/Communities/Thought_Disorders/schizo/nimh/causes.asp
www.psychcentral.com/library/schizo_causes.htm
www.healthcentral.com/schizophrenia/causes.html
Schizophrenia has remained a mystery over centuries and its exact causes are still not very clear, despite decades of rigorous research. Having a biological basis, its manifestations are largely behavioral, with wide social ramifications. The issue of stigma and social isolation makes it even more difficult to provide effective care to those battling against it. Scientists have not yet understood all the factors causing schizophrenia, but all the tools of modern biomedical research are being used to search for genes, critical moments in brain development, and other causes that may lead to the illness.
The possible causes of schizophrenia are:
Genetics
It has been known for long that schizophrenia runs in families. People who are closely related to schizophrenic patients are more likely to develop the disorder than people who have no such incidence. Twins, family and adoptions studies suggest that genetic factors play an important role in the development of schizophrenia. The child of a parent with schizophrenia has about 10 per cent chance of developing schizophrenia; and if both parents are schizophrenics, the risk is increases by 40 percent. If an identical twin has schizophrenia, the risk for the other twin (who has the exact same genes as his/her sibling) is about 50 percent. The chances of developing schizophrenia during their lifetime are 14 percent in case of a fraternal twin. By comparison, the risk of schizophrenia in the general population is about one per cent.
Environment
Possible environmental factors include obstetric complications like exposure to influenza during pregnancy and or nutritional deprivation during pregnancy. It has also been suggested that stress and trauma can lead to the emergence of schizophrenia. New studies show that the innate potential of human nature becomes a reality only when exposed to a certain kind of nurture or environment. Some genes are switched on when a person is exposed to a specific environment such as family stress, conflicts, anger and growing up in an emotionally-charged environment, which impact and damage children's brains. This results in the short form of the 5-HTT gene becoming associated with depression and suicide. Studies that support this new view of how environment combines to influence brain development are increasing rapidly. Research has also shown that the smaller the proportion of an ethnic minority the greater the risk of developing this illness.
´Neuro-developmental´ factors
Research in this area investigates the possibility that individuals who develop schizophrenia in early adult life have suffered some from of cerebral ´maldevelopment in utero´. Prenatal difficulties like intrauterine starvation or viral infections, and various nonspecific stressors, seem to influence the development of schizophrenia. It may also be a developmental disorder resulting when neurons in the brain form the wrong connections during fetal development and these errors may not be noticed until puberty There is a great deal of research being carried out in this area. It appears likely that multiple genes are involved in creating a predisposition to develop this disorder. However, it is not yet understood how the genetic tendency is transmitted, and it cannot yet be accurately predicted if a given person will or will not develop the disorder.
Complications during pregnancy, abnormal fetal growth and complications during delivery are significant risk factors in the development of schizophrenia. These play a significant role in the development of schizophrenia along with these main factors:
(a) Bleeding, diabetes and ´pre-eclampsia´ pregnancy complications
(b) Abnormal fetal growth and development problems including conditions of low birth weight and reduced head circumference
(c) Complications of delivery including asphyxia and emergency
Caesarean delivery
However, the effect of such complications is small in comparison with factors like genetic pre-disposition to schizophrenia.
Several regions of the human genome are being investigated to identify genes that may confer susceptibility to schizophrenia. The strongest evidence but not yet confirmed leads to chromosomes 13 and 6. The anatomical abnormalities found in different parts of the brain tend to correlate with schizophrenia´s positive symptoms and negative symptoms. Many studies of people with schizophrenia have found abnormalities in their brain structure or in the way it functions. It should be emphasized that these abnormalities are subtle and are not characteristic of all people with schizophrenia, nor do they occur only in individuals with this illness.
Studies of brain tissue have also shown small changes in number of brain cells or how they are distributed in people with schizophrenia. It appears that many of these changes are present before an individual becomes ill, and schizophrenia may be in part, a disorder in the development of the brain.
In recent years, there has been growing evidence supporting the role of viral infections including the poliovirus, the flu virus and a virus called ´encephalitis lethargica´ in the development of schizophrenia. Few studies have also shown that the increased risk of schizophrenia appears linked to maternal infections during the first and second trimesters of pregnancy especially flu infections. Since the flu season peaks during the fall, it might explain why babies born in the winter and spring have a higher risk. The research is both exciting and troubling. It suggests that the origins of schizophrenia might start early in the womb. Moreover, symptoms of schizophrenia, which typically emerge in late adolescence or early adulthood affecting about 1 percent of the population, may only be the last stage in a long process. Research into the links between maternal flu and schizophrenia is still considered preliminary, which makes any policy conclusions premature, but scientists studying the connection are starting to worry.
Drug misuse
Although contentious, some research also suggests that substance misuse is related to the development of schizophrenia. It is likely that substance misuse may precipitate or worsen the symptoms and interfere in the treatment of a person with schizophrenia. A recent study has indicated that people who had multiple copies of a version of the COMT gene and who smoked marijuana had a 1,000% increase in their risk of developing schizophrenia. This research may partly explain the increased risk of developing schizophrenia for people who smoke marijuana.
Biochemical factors
Certain biochemical imbalances in the brain are believed to be involved in the cause of schizophrenia. Neurotransmitters have long been thought to be involved in the development of schizophrenia. Although there is no definitive answer yet, this is a very active area of schizophrenia research. Excessive levels of the neurotransmitter dopamine have long been implicated in schizophrenia, but it is not yet clear if the excess is a primary cause of schizophrenia or a result of a more fundamental dysfunction. More recent evidence implicates much greater complexity in the ´dysregulation´ of dopamine and other neurotransmitter systems . Some of this research ties schizophrenia to certain variations in dopamine receptors, while other research focuses on the serotonin system. However, it must also be emphasized that in many cases perturbations in neurotransmitter systems may result from complications of schizophrenia, or its treatment, rather than from its causes.
Schizophrenia being a disorder that commonly befalls younger patients, better-informed people would not only have a better understanding for people with schizophrenia, but also a higher likelihood of detecting this disorder in early stages in their peers, thereby indirectly helping to improve overall outcomes.
The outlook for people with schizophrenia has improved over the last 30 years or so. Although there still is no cure, effective treatments have been developed, and many people with schizophrenia are able to lead independent, satisfying lives. This is an exciting time for schizophrenia research. The explosion of knowledge in genetics, neuroscience, and behavioral research will enable a better understanding of the causes of the disorder, how to prevent it, and how to develop better treatments to allow those with schizophrenia to achieve their full potential.
People with a mental illness who are pressured and criticized usually regress and their symptoms worsen. Motivating them is the best way to help them move forward. Going along with the delusions will not be helpful for their growth. It is best to clear to them that they see things differently than the others do and acknowledge that everybody has the right to see things in his or her own perspective. Being respectful, supportive, and kind without tolerating dangerous or inappropriate behavior is the most supportive way to approach people with this disorder.
I would like to conclude by quoting the lines of Pamela S. Wagner, a prize winning poet and journalist, who was also diagnosed with schizophrenia: "I live in a closet (schizophrenia). Unlike most closets, mine is invisible. No one else can see it or touch it or even come inside to keep me company. Nevertheless, its imprisoning walls and terrifying darkness are very real!"
Credits
Books:
Surviving Schizophrenia by Fuller Torrey
Is There No Place on Earth for Me? by Susan Sheehan
Web sites:
http://www.wrongdiagnosis.com/s/schizophrenia/causes.htm
www.schizophrenia.com
www.healthyplace.com/Communities/Thought_Disorders/schizo/nimh/causes.asp
www.psychcentral.com/library/schizo_causes.htm
www.healthcentral.com/schizophrenia/causes.html
Print
Email
