May 26, 2013 | 03:01 PM (BD Time)
26 May, 2013 Sunday
Schizophrenia, causes, symptoms, and treatment
Schizophrenia is a complex illness. Mental health experts are not sure what causes it. However, genes may play a role.
· Certain events may trigger schizophrenia in people who are at risk for it because of their genes.
· You are more likely to develop schizophrenia if you have a family member with the disease.
Schizophrenia affects both men and women equally. It usually begins in the teen years or young adulthood, but it may begin later in life. It tends to begin later in women, and is milder.
Childhood-onset schizophrenia begins after age 5. Childhood schizophrenia is rare and can be hard to tell apart from other developmental problems in childhood, such as autism.
No single cause can account for schizophrenia. Rather, it appears to be the result of multiple causes such as genetic factors, environmental and psychological assaults, and possible hormonal changes that alter the brain's chemistry.
Brain scans using magnetic resonance imaging (MRI) have shown a number of abnormalities in the brain's structure associated with schizophrenia. Such problems can cause nerve damage and disconnections in the pathways that carry brain chemicals.
Because these problems tend to show up on brain scans of people with chronic schizophrenia rather than newly diagnosed patients, some doctors believe they may be a result of the disease and its treatments rather than a cause. (Medications used for schizophrenia can also cause brain shrinkage over time.)
Abnormal Brain Chemicals. Schizophrenia is associated with an unusual imbalance of neurotransmitters (chemical messengers between nerve cells) and other brain chemicals, such as dopamine overactivity, glutamate, reelin, and others. Whether any changes in these chemicals in the brain is a cause or a consequence of schizophrenia remains unclear.
Abnormal Circuitry. Abnormalities in brain structure are also reflected in the disrupted connections between nerve cells that are observed in schizophrenia. Such miswiring could impair information processing and coordination of mental functions. For example, auditory hallucinations may be due to miswiring in the circuits that govern speech processing. Strong evidence suggests that schizophrenia involves decreased communication between the left and right sides of the brain.
Schizophrenia undoubtedly has a genetic component. The risk for inheriting schizophrenia is 10% in those who have one immediate family member with the disease and about 40% if the disease affects both parents or an identical twin. Family members of patients also appear to have higher risks for the specific symptoms (negative or positive) of the relative with schizophrenia.
Researchers are seeking the specific genetic factors that may be responsible for schizophrenia in such cases. Current evidence suggests that there are a multitude of genetic abnormalities involved in schizophrenia, possibly originating from one or two changes in genetic expression. Scientists are beginning to discover the ways in which specific genes affect particular brain functions and cause specific symptoms. Genes that have been studied include the neuregulin-1 gene, the OLIG2 gene, and the COMT gene.
Heredity does not explain all cases of the disease. About 60% of people with schizophrenia have no close relatives with the illness.
The case for viruses as a cause of schizophrenia rests mainly on circumstantial evidence, such as living in crowded conditions. The risk is higher for people who are born in cities than in the country. The longer one lives in the city, the higher the risk. The following are some studies suggesting an association:
· Winter and Spring Births. The risk for schizophrenia worldwide is 5 - 8% higher for those born during winter and spring, when colds and viruses are more prevalent.
· Large Families. The risk for schizophrenia is also greater in large families in which there are short intervals between siblings (2 or fewer years). Such observations suggest that exposure to infection early in infancy may help set the stage for later development of the disease.
· Pregnant Mother's Exposure to Viruses. The mother's exposure to viral infections such as rubella, measles, chicken pox, or others while the infant is in the womb has also been associated with a higher risk for schizophrenia in her child.
· Researchers are trying to identify specific viruses that may be responsible for some cases. Of particular interest is research finding evidence of a virus that belongs to the HERV-W retrovirus family in 30% of people with acute schizophrenia.
Some research has found an association between some cases of schizophrenia and toxoplasmosis, a parasite carried by cats and other domestic animals. Several studies suggest that patients with schizophrenia have an increased prevalence of antibodies to toxoplasmosis. Toxoplasmosis can lie dormant in the nervous system and migrate to the brain over many years.
Although parental influence is no longer believed to play a major role in the development of schizophrenia, it would be irresponsible to ignore outside pressures and influences that may exacerbate or trigger symptoms. The prefrontal lobes of the brain, the brain areas often thought to lead to this disease, are extremely responsive to environmental stress. Given the fact that schizophrenic symptoms naturally elicit negative responses from the patient's circle of family and acquaintances, negative feedback may intensify deficits in a vulnerable brain and perhaps even trigger and exacerbate existing symptoms.
Schizophrenia symptoms usually develop slowly over months or years. Sometimes you may have many symptoms, and at other times you may only have a few symptoms.
People with any type of schizophrenia may have trouble keeping friends and working. They may also have problems with anxiety, depression, and suicidal thoughts or behaviors.
At first, you may have the following symptoms:
· Irritable or tense feeling
· Trouble concentrating
· Trouble sleeping
As the illness continues, you may have problems with thinking, emotions, and behavior, including:
· Bizarre behaviors
· Hearing or seeing things that are not there (hallucinations)
· Lack of emotion (flat affect)
· Problems paying attention
· Strongly held beliefs that are not real (delusions)
· Thoughts that "jump" between different topics ("loose associations")
Symptoms depend on the type of schizophrenia you have.
Paranoid schizophrenia symptoms may include:
· Anger or arguing
· False beliefs that others are trying to harm you or your loved ones
Disorganized schizophrenia symptoms may include:
· Childlike behavior
· Problems thinking and explaining your ideas clearly
· Showing little emotion
Catatonic schizophrenia symptoms may include:
· Grimacing or other odd expressions on the face
· Lack of activity
· Rigid muscles and posture
· Not responding much to other people
Undifferentiated schizophrenia may include symptoms of more than one other type of schizophrenia.
During an episode of schizophrenia, you may need to stay in the hospital for safety reasons.
Antipsychotic medications are the most effective treatment for schizophrenia. They change the balance of chemicals in the brain and can help control symptoms.
These medications are usually helpful, but they can cause side effects. Many side effects can be managed, and they should not prevent you from seeking treatment for this serious condition.
Common side effects from antipsychotics may include:
· Feelings of restlessness or "jitters&
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