Schizophrenia

Summary

Schizophrenia is a severe psychosis that affects young adults characterized by personality disintegration and loss of contact with reality.

It is manifested by acute episodes of psychosis that may include hallucinations, delusions and various chronic symptoms resulting from emotional, intellectual and psychomotor problems.

The causes of this complex disease are still controversial but it is considered, at least partially, hereditary.

So, if both parents are affected, it is estimated that the risk of the child being schizophrenic is between 40% and 68%.

Canadian researchers demonstrated in 2010 the role of genetic mutations that may predispose certain people to schizophrenia.

The main treatments for schizophrenia can be medication (neuroleptics or antidepressants) and/or psychotherapy.

Definition

Schizophrenia is a mental disorder, a chronic or recurrent psychosis found mainly in young adults that can cause long-term deterioration in functional capacity.

Etymologically, schizo comes from the Greek and means separation, and frenia, state of mind. Eugen Bleuler (1857-1939), a Swiss psychiatrist named the disease characterized by mental dissociation with personality transformation.

Psychosis is a break in reality that manifests itself through a combination of delusions, hallucinations, chaotic behavior and disorganized/incoherent thinking. Other illnesses can be characterized by psychosis and must be ruled out before making the diagnosis of schizophrenia.

The causes of this psychosis are complex and could occur due to several biological, sociological and psychological factors.

The treatment of this disease has evolved a lot, since in the past the inmates were treated by electroshock and today they receive psychotropic drugs from the neuroleptic class.

It is estimated that around 1% of the population suffers from schizophrenia, this represents, for example:

– In Brazil, about 2 million people

– In France, around 630,000 people

This disease is very common, affects people without cultural, economic or social distinction.

The disease usually starts between 15 and 50 years of age.

Epidemiology

Worldwide, the WHO estimates that this serious mental disorder affects 24 million people (2011 data), approximately 0.3% of the world’s population.

Causes

The causes of the disease are complex and still hypothetical. It is believed that they would be biological, sociological and psychological.

– Biological causes: Schizophrenics who suffer hallucinations (positive disorders) would have an increase in dopaminergic activity (dopamine is a substance involved in nerve transmission). Neuroleptics (psychotropic drugs) are used to relieve these patients.

We know that genes can play a factor in the onset of schizophrenia. In identical twins, if one twin is affected, the probability that the second twin will suffer from schizophrenia is between 30% and 50%.
There are at least 108 genes associated with schizophrenia, according to the Schizophrenia Working Group of the Psychiatric Genomics Consortium .
In a large study of twins, researchers at the University of Copenhagen found that in about 79% of cases, schizophrenia can be explained by genetic causes. More than 30,000 pairs of twins born after 1870 have been studied thanks to the   Danish Twin Register database . This study was published August 30, 2017 online in the scientific journal Biological Psychiatry (DOI: 10.1016 / j.biopsych.2017.08.017).

– Sociological and psychological origins: Apparently some of the triggering factors would be problems in childhood and in the social environment. The patient would have suffered some weakening during his first years of life due to intense affective disturbances in his family relationships, mainly with his parents. And later, under the shock of some late but intense event, he would succumb to the disease. Other social factors may be causative, such as: moral isolation and unfavorable social conditions. In other words, physical or emotional trauma during childhood can be at the origin of schizophrenia.1.

– “Toxological” origins: Some experts believe that marijuana could favor schizophrenia, however there is a controversial debate on this subject, whether it would be a revealing or a deep cause of the disease.

– Genetic origins: Apparently the risk of developing schizophrenia is higher for people with family members with schizophrenia and bipolar disorder. Studies indicate that the NRG1 gene may be associated with schizophrenia.

Inflammation, possible cause

Some researchers believe that schizophrenia may have, in some patients, an inflammatory origin. In fact, scientists observed that 40% of psychiatric patients had excessive levels of molecules typical of an inflammatory reaction (eg cytokines, C-reactive protein) in their blood.

That is why psychiatrists do not hesitate to prescribe non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or celecoxib to complete the treatment of psychiatric illnesses such as depression.

– A parasite . Numerous studies have shown a correlation between people suffering from schizophrenia and the presence of the parasite Toxoplasma gondii , which causes toxoplasmosis . This means that more people with schizophrenia have Toxoplasma gondii in their brains than those without schizophrenia. We can cite a study carried out with American soldiers published in 2008 in the American Journal of Psychiatry (DOI: 10.1176/appi.ajp.2007.06081254 ).

Groups of risk

The disease starts essentially in young adults, men or women (between 15 and 34 years old).

Schizophrenia is 0.4 times more frequent in men than women. This means that every 12 schizophrenics, 7 are men. Men apparently show symptoms earlier and have a worse prognosis (course of disease) than women.

Schizophrenia can be hereditary, so a person who has a family history of the condition is at a higher risk of developing it.

Symptoms

The disease is characterized by personality disorders, the presence of psychosis, social withdrawal, as well as extreme emotional reactions without connection (laughing after news of a death).

The main features of the disease are: psychosis, decrease or loss of normal characteristics (normal reactions), cognitive impairment and affective disorder.

The main manifestation of psychosis in schizophrenics is delirium, followed by hallucinations (auditory, gustatory, visual, etc.). Chaotic behavior and disorganized/incoherent thinking are also present (positive symptoms).

NA Loss or decrease of normal characteristics refers to loss of affective responsiveness (facial expressions), verbal expression, personal motivation, pleasure, social contact or attention to the environment in which we live (negative symptoms).

Cognitive impairment affects attention, memory, language and task performance, and may affect academic and professional performance.

On the occasion of his negative disturbances, the patient closes himself in his own world and cuts off relations with the outside world.

Diagnosis

The diagnosis is psychiatric, there are no characteristic lesions or laboratory findings that confirm the disease.

The doctor will carry out an analysis, taking into account the symptoms of psychosis, functional deterioration, the patient’s current life context, as well as genetic predispositions (family history, heredity). The possibility of other illnesses leading to psychosis must be ruled out.

Some techniques are used to determine psychosis, such as interviews, observation of behavior, reports from family members and close people.

The doctor can question the patient by asking if he hears voices, sees or hears things that others do not, feels followed or spied on, has special abilities or powers, if people are listening to his thoughts and if they are trying to send secret messages through different means. of mass communication.

Complications

Schizophrenia is a psychosis with different symptoms (delusions, hallucinations, affective disorders) and it can be difficult for the patient and those around him to bear it.

Thanks to research, the development of neuroleptics (psychotropic medications) reduced hallucinations and helped the patient to return to community life.

Here are the different possible evolutions:

– Continuous forms: progressive worsening of the disease

– Oscillating forms: phases of remission interspersed with phases of disease worsening

– Control: with the possibility of returning to community life, but with essential psychological and therapeutic support.

– Suicidal state: the risk of suicide is high in schizophrenics

Some illnesses are associated with schizophrenia:

– Obesity

– Type 2 diabetes

Schizophrenia may directly increase the risk of diabetes , according to a study published in January 2017 in the journal JAMA Psychiatry . The risk of suffering diabetes for people with schizophrenia would be 3 times higher than among the general population. These results come from a study by researchers at King’s College , London. People who are affected by schizophrenia have a lower life expectancy, of up to 30 years, when compared to the rest of the population, mainly because this psychiatric illness increases the risk of suffering from a heart attack or stroke due to diabetes, as a important risk factor.

– Hyperlipidemia (high cholesterol)

– Heart problems

Treatments

The treatment of schizophrenia has evolved a lot over the years, in the past patients were hospitalized with no hope of returning to community life and received electroshocks to calm them down when they were delirious.

Nowadays, scientific progress and the development of medicines have given patients the possibility of returning to a normal life, calming their hallucinations and delusions.

As schizophrenia has no cure, drug treatment based on antipsychotics (neuroleptics) should be maintained, as well as psychological monitoring (eg psychotherapy) and constant observation in relation to relapses.

Schizophrenia medication and care

The drugs used in the treatment of schizophrenia are essentially neuroleptics and antidepressants.

– Antipsychotics (neuroleptics): they form part of a large therapeutic class, regrouping several drug classes such as phenothiazines (chlorpromazine, thioridazine, fluphenazine, among others); butyrophenones (haloperidol) and atypical drugs (clozapine). Neuroleptics act on the nervous transmission of dopamine and alleviate hallucinatory delusions and behavioral disorders.

With antipsychotics, most patients can see some of the severe symptoms of schizophrenia, such as hallucinations, stop after the first month of treatment. However, the long-term results are poor, with a relapse in 80% of patients, as revealed by the University of Manchester in a press release about a study of the high intake of food supplements based on B vitamins and their positive impact on the symptoms of schizophrenia (learn more about the reference studies below in Tips) .

– Antidepressants: as we saw in the schizophrenia symptoms section, the disease can cause anxiety in the patient. This class of drugs alleviates this symptom.

Psychological treatment of the patient includes social skills training and vocational rehabilitation.

Psychological treatment is also recommended for family members, educating and helping the family to deal with the problems of the disease, social prejudices and stress. Family treatment helps to improve the patient’s condition.

Anti-inflammatories and schizophrenia

As schizophrenia can, in certain patients, have an inflammatory origin, some physicians prescribe non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or celecoxib to complete the therapy. Also read Causes for more information.

Some doctors also sometimes use minocycline, an antibiotic that has anti-inflammatory action. In this case, it is not the antibiotic action that will take effect, but its anti-inflammatory properties.

Tips

– It is essential that the doctor’s instructions are followed and that the medication is not abruptly interrupted.

– Marijuana can trigger schizophrenia, so we advise you not to use this drug, especially if you are psychologically fragile or if you have a family history of mental illness. Studies indicate that marijuana consumption anticipates the onset of psychotic illnesses.

– A study by the University of Manchester (England) published in August 2016 in the specialized journal Schizophrenia Bulletin,showed that the regular practice of aerobic physical exercise makes it possible to increase the mental health, in the long term, of people suffering from schizophrenia. Scientists observed that after 12 weeks of aerobic exercise, such as running or cycling, the brain function of people with schizophrenia increased significantly. To reach these conclusions, the researchers combined data from 10 clinical studies on this topic, totaling 385 patients. Patients who exercised and took their schizophrenia medication improved their brain function more than those who took medication alone. It is known that schizophrenia can lead to cognitive impairment and lower brain performance.

– Consume high doses of vitamin B if you or a family member suffers from schizophrenia. According to a review of studies (meta-analysis) carried out worldwide by the University of Manchester in England, taking vitamin B in high doses, including vitamins B6, B8 and B12 in the form of a food supplement allows to significantly reduce the symptoms of schizophrenia, more than standard treatments alone. This research was published in the journal Psychological Medicine in February 2017.

Prevention

– Marijuana can be a trigger for schizophrenia, so we advise you not to use this drug, especially if you are psychologically fragile or if you have a family history of mental illness.

 

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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