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A particular type of psychosis, schizophrenia is perhaps one of the most debilitating and chronic of the severe mental illnesses

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Introduction

A particular type of psychosis, schizophrenia is perhaps one of the most debilitating and chronic of the severe mental illnesses. For a long time, schizophrenia was seen as a 'functional disorder' with some doctors calling it a sociological phenomenon - i.e. patients with schizophrenia are normal people driven insane by the insane world (Gelder, et al., 1989). However, the efficiency of antipsychotic drugs and recent advances in biological research have countered this 1970s concept. Revolutionary scientific advances in neuroscience, molecular biology, genetics and brain imaging over the years have provided credible evidence for the biological bases underlying schizophrenia. There have been many theories of possible causes. For instance, many years of family studies indicate that a susceptibility to schizophrenia might be inherited. However, scientists still do not know how many genes are involved or how the genetic predisposition is transmitted, and how the environment may interact with it. Another line of research has identified specific, subtle abnormalities in the structure and function of the brains of schizophrenic patients and provided the evidence for notable, early biochemical changes. Developmental neurobiologists on the other hand suggest that schizophrenia may be a result of the neurons forming inappropriate connections during fetal development. Because of so many possible explanations, it is no surprise that the research into the causes of schizophrenia still remains one of the most challenging areas for medical investigators. ...read more.

Middle

have been consistent in finding loss of temporal lobe volume and loss of temporal lobe gray matter in schizophrenia sufferers. The areas which were found to be most affected are the limbic forebrain, (especially the amygdala and the hippocampus), and the basal ganglia (including the caudate, nucleus accumbens, and olfactory tubercle). Freedman et al., (1995) found that skull volume is reduced in persons with schizophrenia by 3.5%. Since brain growth drives skull growth, these findings suggest that the process causing schizophrenia takes place prior to the completion of brain growth (approximately age 18) (Elkis, et al. 1995). In fact, studies by Fish et al., (1992) and Marcus et al., (1993) demonstrated the presence of mild neurological impairments even in the infants of schizophrenic parents. This strongly suggests that the process leading to schizophrenia is a developmental error occurring prior to birth, rather than a degenerative or destructive process. The view of developmental neurobiologists supports this claim. They suggest that schizophrenia may be a developmental disorder resulting from neurons being miswired during fetal growth. These errors may lie dormant until puberty, when changes in the brain that occur normally during this critical stage of maturation start interacting adversely with the faulty connections. This research has spurred efforts to identify prenatal factors including infections in utero that may affect development (Murray, et al., 1992). One of the first bits of evidence to support this hypothesis came in 1988 from the study by Mednick et al, of children born to women who had been pregnant during a severe flu epidemic in Helsinki, Finland, in 1957. ...read more.

Conclusion

However, the current status of research on genes and schizophrenia has not yet uncovered the specific genes that underlie the disease. And even if that takes place, some researchers such as McGue & Gottesman (1989), admit that analysis of individual genes alone will not give us a full understanding of the causes of schizophrenia. The disease is most definitely a result of interactions of complex systems, therefore a systems approach is needed for understanding its development. Basic knowledge about brain chemistry and its link to schizophrenia is also expanding rapidly and this area of research looks very promising. It is clear today with the firm findings of reduced frequency, duration, and severity of psychotic episodes in persons treated with anti-psychotic medication that dopamine has a major role to play in schizophrenia like disorders. However, it is not known whether the change in the dopamine activity occurs before or after the onset of the illness. If it occurs after, than overactive dopamine is just another symptom in a long list of symptoms associated with schizophrenia (Jones & Pilowsky, 2002). It may well be that schizophrenia is not a single disorder at all, but rather that it represents a final common syndrome of behaviours and findings about mental status with multiple possible causes. Understanding these causes will be critical for the medical care of patients suffering from schizophrenia, so the doctors can if not cure, then at the least alleviate the suffering this disease brings on the patient and their family and friends. ...read more.

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