Introduction of Schizophrenia

Schizophrenia is a very serious illness that is related to the brain, in short, it is a mental illness that directly causes an effect on the ability of an individual that how he perceives the world and people living around them the same likely how others do. Most of the people having this mental illness start listening to the voices around them of the things that are not there. People having this mental illness may also have false beliefs related to the world and they vary in the content. People having this mental disease start interpreting the reality which is known through losing contact with the environment and then they also start having trouble while functioning daily. If it remains untreated, in later stages can also result in psychosis which is far more severs and serious in which patients completely lose the touching reality. (Arieti, Silvano. 1995)

History of Schizophrenia

 Origins of Schizophrenia

This mental illness from the name of Schizophrenia is known for less than 100 years and it means “splitting of the mind”. This disease for the very first time was identified as a discrete mental illness and the person who told about it was Dr. Emile Kraepelin in the year of 1887 and this disease is accompanying mankind since the history of mankind. Many different written documents help in identifying that Schizophrenia can also be traced with the old Pharaonic Egypt. Dementia and depression both of these are typical in schizophrenia and described in detail in the Book of Hearts. In ancient Egypt, both the heart and brain have been synonymous. In previous times, physical illness was regarded as the symptoms related to uterus, heart, fecal matter or a poison. (Gottesman, Irving I. 1991)

Swiss psychiatrist with the name of Eugen Bleuler named the term with “Schizophrenia” back in the year 1911. He was the very first person who described the symptoms of these diseases as positive or negative. Bleuler changed the name of this disease from Krapelin’s to Schizophrenia as the previous name was becoming a source of misleading as this illness was not dementia. Sometimes it occurs early in life while sometimes late.

Bleuler and Kraepelin both of them subdivided Schizophrenia into different categories based on their prognoses and symptoms.

There was a point in history when people who were considered normal due to physical deformities, mental retardation or mental illness all of them were treated with the same medication. There were no separate treatments for such diseases as in the present era. Different early theories stated that mental illness was caused to any individual due to the demons and their treatment was the only exorcism.

It is a very severe and serious kind of mental illness and affecting round about 300,000 people only from Canada, men and women both have the same frequency.

- The general population is at the risk of 1%

-  5% risk for the parents

-  9.7% risk for the siblings whose parent don’t have this mental illness

-  17.2% risk for the siblings whose mother or father, one of them is schizophrenic

-   Siblings whose both parents are schizophrenic are at 46.3% risk

Diagnostic Criteria of Schizophrenia

Signs and symptoms of Schizophrenia

There are five basic symptoms which help in the characterizing of schizophrenia and they are:

· Delusions

· Hallucinations

· Disorganized patterns while behaving

· Disorganized in speech patterns

·  Absence of normal behaviors like lacking in the emotional expressions, lack of interest in the world and people around that person.

Schizophrenia is a mental illness that is further divided into three different categories and they are:

Positive: This refers towards the different metal experiences which are being added to the normal experience or behavior of an individual and it includes (Delusions, hallucinations, abnormality in behavior and the disorganized manner in speech)

Negative: This refers to the reduction in the level of capacity like lacking in the pleasure, motivation level and interests in life. Individuals are not that much goal-oriented and they lack in the emotional expressions as well. (Piotrowski, Patryk, et al. 2017)

Cognitive symptoms include the struggle for the maintenance of memory and having different organized thoughts. This also includes the tasks which are being required daily.

Now the symptoms of this mental illness appear differently in men and women. In the men, the symptoms start appearing in the mid of 20 years while in women it appears after the 20s. While in the case of children and adults age above 45 is more of a rare factor.

Overlapping of this symptom at times also causes other things as well that include the list of depression, reactions of different medicines, delusions, alcohol use, and drug abuse as well.

 Physiology of Schizophrenia

Physiology of this mental illness is related to the brain and this disease is being caused when certain changes in the brain structure take place and these changes are mentioned below:

o  Enlargement of the ventricles present in the brain. This happens basically when the natural system for absorbing and then draining off extra CSF stops working properly according to their function. Slow enlargement of the ventricles in the brain starts taking place and it means the pressure of fluid in the brain may not be as higher as in the other types of the hydrocephalus. (Kingdon, David G., 1994)

o  The decrease in the volume of grey matter, it is the major part of a central nervous system and it consists of several neuronal cell bodies, glial cells, neuropil (it includes dendrites and myelinated along with the unmyelinated axons), capillaries and the synapses. Reduction in their volume is another reason for the physiological change in the brain and that causes Schizophrenia.

o  Cell atrophy is the decrease of size as well as activity of the cell number and it occurs due to the reduction of blood supply, poor nutrition or can be due to the decrease in normal hormonal stimulation. This is another cause of mental illness.

o  Reduces the volume of the thalamus is another reason for causing a physiological change in the brain that becomes the reason for mental illness.

Physiological change in the brain disrupts the migration of different neurons in the brain that further increases the neural density and causes a missing in the inhibitory of interneurons.

 Demonology of Schizophrenia

As symptoms of this mental illness are very strange like hallucinations and delusions, therefore many doctors still believe that this disease is being caused by the demons and the only treatment for this disease is an exorcism. This thinking is most of those who are from villages and believe in demons and their existence. They are still not well aware of the latest studies and terms and obviously, they do require time for it. Above all, ancient people also used to think the same about such mental illness and this is the reason that people still relate this disease with ancient times. But it has been proved that the cause of this disease is due to some of the physiological changes that take place in the brain.

 Causes of Schizophrenia

People having this mental illness Schizophrenia have a different structure of the brain as compared to the ones who don’t suffer from this mental illness. Different researches have been done and it is clear enough by now that the cause of this mental illness is related to the different kind of problems that involves the brain chemistry and their structure, another reason of this can also be hereditary.

It has been known and discussed above as well that people or children whose parents are affected by these diseases have more chances of having it in the future.

Genes of Schizophrenia

Another research also states that there are different enzymes present due to which these diseases take place when they don’t work properly or stop working at all. (Kallmann, Franz Josef. 1938)

Types of genes involved in Schizophrenia brain

- NRG1 (Neuregulin 1)

- DTNBP1 (Dystrobrevin Binding Protein 1)

- G72 (D- Amino Acid Oxidase Activator)

- DAAO (D- Amino Acid Oxidase)

-  RGS4 (Regular of G Protein Signaling 4)

-  COMT (Catechol-O-Methyltransferase)

-   PRODH (Proline Dehydrogenase 1)

 Receptors involved of Schizophrenia

 Schizophrenia is a disease as earlier told that has been with mankind since the known history with different names but the same misery it has caused to people. Multiple reasons contribute to schizophrenia. The human body is a complex system and is a world in itself. Schizophrenia affects many receptors and there are multiple receptors involved in it. Dopamine has been the most earlier identified neurotransmitter behind the disease. Dopamine affects the cognition skills and causes a generic degradation of the other receptors. It has been found in research that the dopamine receptors over activity sends a ripple effect to other receptors involved and causes a neurochemical imbalance. The other receptors include glutamate, GABA, acetylcholine, and serotonin. More recent research show how the Central nervous system and primary receptors cause the effects of disease and contribute to the neurological degradation of the human body.

  Treatment of Schizophrenia

This disease is long-lasting and there are very few chances of a person’s recovery from this mental illness but with the own willingness of a person along with some other techniques a person can become normal as before.

Diagnosis of Schizophrenia

In the diagnosis of this mental health disorder, different tests and screenings can be done for drugs and alcohol through which it can become clear enough that a person is suffering from this disease or it is just because of the overdose of drugs and alcohol. MRI and CT scan be done for its diagnosis.

While looking for mood swings, hallucinations and delusions are other types of diagnoses that can be done by the psychiatrist very well. One should also consult the psychiatrist because there can be any other reason as well for all such symptoms.

Medications of Schizophrenia

Medication can also be done to treat this mental disorder and one needs to continue them for as long as the doctor prescribes. Antidepressants and anti-anxiety medicines are also given in some cases with different doses according to the condition of the patient. Medication needs to be done for a long period as this disease is not a small one but along with this, the patient needs to show their will of recovery as well and only then a person can recover. (Gillespie, Amy L., et al. 2017)

Therapy of Schizophrenia

Therapy is another kind of treatment that is being done for the recovery of such patients and to bring them back to life. It includes a different kind of therapies:

o  Individual therapy is a session in which the patient comes alone and during the session with a psychiatrist or therapist, he or she becomes able to know how to have control of the thoughts and behavior. They are asked to talk about their thoughts and the techniques are being told to them for their controlling. It gives them relaxation.

o  Social skills training involves a different kind of learning activities which utilizes the techniques related to behavior and it enables a person having schizophrenia to acquire the interpersonal management of diseases and also helps them for the improved and better functioning in the community plus people who live with them.

o   Family therapy is the most important part as the patient spends most of the time with their family. Instead of leaving that person all alone make sure to spend time with them and act normal as nothing has happened. Try to indulge them in different activities which divert their mind. 

o  Electroconvulsive therapy is a session when any of the patients stops responding to drug therapy. This is a medical treatment and is given to only those patients who have this disease very severe and they stop responding to all other treatments. This is the treatment that involves a brief stimulation of electric signals to the brain when the patient is under anesthesia and he or she is unaware that what is happening to them. This is the most severe form of treatment to make sure people get out of their depression or any other bipolar disease.