| Schizophrenia affects around 1% of the population of | | | | implicated in schizophrenia, such as dopamine, |
| this planet. It is a chronic, severe, and disabling mental | | | | glutamate and GABA. Other genes code for proteins |
| disorder. It has also been recognized for centuries, | | | | involved in the brain development, while others code |
| maybe not with the same nomenclature, but most | | | | for proteins of yet undetermined function". (NIMH - |
| likely with the same symptoms. However, the | | | | National Institute of Mental Health**). |
| complex mechanisms which cause this condition | | | | Facts and the treatments |
| remain a mystery of their own…but for how | | | | Schizophrenia is a chronic and disabling disorder, but |
| long? | | | | nevertheless misinterpreted by the general population. |
| History of Schizophrenia: from demons to genes | | | | In fact, between 25 and 40% of people who |
| The symptoms commonly associated with | | | | experience a psychotic episode not only recover, but |
| schizophrenia are on the records of many ancient | | | | never experience a second episode. In many |
| civilizations, such as the Greeks, Romans and | | | | instances, patients enter hospital care voluntarily, and |
| Egyptians. The causes for this mental disorder have | | | | are able to function normally when not experiencing |
| been associated with demons, gods, poisonous | | | | an episode. Although people with schizophrenia are |
| substances, dark creatures and more - but until | | | | more likely to attempt suicide, they are not |
| today, there are still no definite answers. There is | | | | particularly prone to violence or crimes. |
| evidence, however, to the different treatments | | | | Over the last few years, new anti-psychotic |
| tested (and used) in several patients. Drilling holes in a | | | | medications have been developed - such as clozapine, |
| patient's skull and performing dance rituals were | | | | risperidone and olanzapine. These drugs do not cure |
| some of them. | | | | schizophrenia, but they effectively alleviate its |
| The term 'Schizophrenia' (derived from the Greek | | | | symptoms and extrapyramidal side effects (such as |
| words 'schizo'=split and 'phrene'=mind) was only | | | | rigidity, muscle spasms and tremors) which used to |
| created in 1911 by Eugene Bleuler, a Swiss physician. | | | | appear in older drug treatments. |
| Bleuler changed the term 'dementia praecox' created | | | | Psychosocial treatment is also important in the |
| by Emile Kraepelin - the German physician who first | | | | management of schizophrenia. Rehabilitation and |
| classified mental disorders in categories - because the | | | | substance abuse treatment are helpful in integrating |
| disorder was not a dementia. Later on, both scientists | | | | the patient to the society, and improving the |
| sub-classified schizophrenia into categories based on | | | | patient's capability to counteract the degenerative |
| specific symptoms, three of which were delineated in | | | | effects of the disease. Cognitive Behaviour Therapy |
| the DSM-III (Diagnostic and Statistical Manual of | | | | (CBT) can also help. This treatment seems to be |
| Mental Disorders): disorganized, catatonic, paranoid, | | | | effective in reducing the severity of symptoms and |
| residual, and undifferentiated. Kraepelin's classification | | | | decreasing the risk of relapse in patients which |
| remains influential and it is the basis of the DSM-IV. | | | | symptoms persist even when they take medication. |
| Nowadays, it is believed that schizophrenia is caused | | | | Furthermore, the efficacy of treatment can be vastly |
| by a mixture of gene interaction and environmental | | | | improved with the participation of family and friends. |
| influence. However, it is not clear how much influence | | | | Because the positive symptoms of this mental illness |
| each of these causes wields. | | | | are easy to distinguish, both patient and relatives are |
| The Symptoms | | | | able to act when noticing the prevalence of different |
| The symptoms of schizophrenia are divided into | | | | behaviour. |
| three categories: positive, negative and cognitive. | | | | Overcoming schizophrenia: too far or too close? |
| Positive symptoms are volatile, easy to recognise and | | | | The future of schizophrenia runs parallel to most |
| normally involve some loss of contact with reality. | | | | research in mental health. With the advent of new |
| Hallucinations (distortions of the human senses), | | | | brain mapping and scanning technologies, such as |
| delusions (false personal beliefs) and movement | | | | PET, MRI, fMRI and the developments in genetic |
| disorders are examples of such symptoms. | | | | research - scientists are narrowing their focus to the |
| Negative symptoms are harder to recognise as they | | | | interaction between neurons and how each of our |
| relate to some loss in abilities such as planning, | | | | cognitive functions affect neurotransmission at a |
| speaking, expressing emotions or being motivated. | | | | molecular level. With this in hand, there are |
| These symptoms can easily be misconnected to | | | | expectations that the approach to schizophrenia will |
| laziness, depression or other conditions which involve | | | | be more specific and efficient - but to predict cure at |
| similar behaviour. The term is referred as 'negative' | | | | this stage, is a long shot. |
| due to the reductions in 'normality' - both emotional | | | | Nevertheless, there may be more excitement in the |
| and behavioural. | | | | other side of the spectrum. Identifying the exact |
| Cognitive symptoms relate to problems in normal | | | | gene combination which increases the incidence of |
| cognitive functions. In many cases these cognitive | | | | this condition, and the role of non-genetic factors, |
| impairments are only detected through | | | | may still seem distant. However, another solution |
| neuropsychological tests. Such symptoms include | | | | could effectively help the vast population suffering |
| problems with memory, attention, decision-making | | | | from the symptoms of schizophrenia. |
| and more. | | | | The general thinking is that the best way to combat |
| The Causes | | | | an illness is to develop a cure. What about instead of |
| As previously noted, schizophrenia is believed to be | | | | finding the cure, combating the symptoms? That is |
| caused by a mixture of gene and environmental | | | | the approach used for most illnesses which cure is |
| influence. Davies stated that "schizophrenia appears | | | | yet to be discovered, and it could be a temporary |
| to be caused by abnormalities in the development of | | | | solution to improve the lives of millions. Cognitive |
| the brain that become manifest in late adolescence | | | | enhancers, such as nootropics (cited in a previous |
| or the early twenties, a time when a differentiation | | | | edition of this ezine) and cognitive enhancing methods |
| and maturation of the central nervous system is at | | | | - such as the use of electric waves in specific brain |
| its most complex" (Davies 2005 p. 210*). However, | | | | regions - could counteract some of the debilitating |
| the disorder is not characterised by a single | | | | symptoms of schizophrenia. |
| predominant gene - it relies on the combination of a | | | | Most of these techniques are still being tested, but |
| group of genes, each exerting a small effect. These | | | | they are much closer to reality and have already |
| gene combinations, along with the presence | | | | predictions to reach the market within a few years. |
| non-genetic factors such as exposure to viruses or | | | | Although there have been some studies in cognitive |
| drug abuse, play a key role of increasing vulnerability. | | | | enhancing drugs, new drug classes are on the scene - |
| Current research is attempting to identify the genes | | | | and brain science and pharmacology are allowing |
| which could be directly involved with the incidence of | | | | further discoveries in the field. What will be the next |
| schizophrenia and psychotic episodes. There are | | | | step? That might not be the one million dollar |
| candidate genes - however there is not enough | | | | question, but perhaps it holds the answer which over |
| evidence to prove that these genes in fact increase | | | | 65 million people have been waiting for. |
| risk. "Some genes that have recently been associated | | | | Sources |
| with schizophrenia code for enzymes and proteins | | | | *Davies, J. (November 2005) A Manual of Mental |
| that help brain cells communicate with each other. | | | | Health Care in General Practice, Commonwealth |
| Some of these enzymes and proteins are involved in | | | | Department of Health and Ageing, Canberra. |
| neurotransmitter systems that have long been | | | | |