Schizophrenia is a chronic degenerative brain disorder that affects an individual’s ability to function in the ideal self-sufficient manner. Initially manifested as a subtle behavioral deviation, schizophrenia symptoms, if left untreated, can escalate into severe deterioration of a person’s cognitive, emotional, and physical performance. Research about the disorder addresses the infamous nature vs nurture debate, explores the spectrum of symptoms, and tries to determine the exact boundaries of a disease that has impacted our society for hundreds of years.
Prevalence of Schizophrenia Disorder
Schizophrenia is an equal opportunity disorder, at least regarding sex and ethnicity. Although males may exhibit symptoms earlier on than females, both sexes are equally likely to be diagnosed with the disorder. Somewhat rare, schizophrenia affects about 0.2% to 1.5% of the population, however studies into the disorder reveal strong correlations between the amount of genes shared with an individual and the corresponding likelihood of developing the disorder. For example, if we look at the amount of genes shared amongst relatives, going in descending order, we see that monozygotic twins (who share 100% of their genes) have the highest probability (about 48%). We then start to see a decrease with fraternal twins (who share 50% of their genes) and have a 17% risk and finally look at individuals with any other relative who has been diagnosed with the disorder, and see that these individuals have about a 1% risk. It is also important to note that having a relative with the disorder is the primary predicting factor of risk associated with developing schizophrenia. After identifying a family history of the disorder, we then look at the severity of symptoms and the amount of genes shared between the individual at risk and the family member diagnosed, to determine a more accurate statement of probability. It is also important to note that while genetics play a large role in predicting probability of developing the disorder, they cannot predict what symptoms are likely to manifest, as studies reveal that even monozygotic twins can have very different forms of schizophrenia. It is more accurate to state that a family history of schizophrenia can be a reliable predictor of a psychotic disorder with schizophrenia-specific symptoms. Schizophrenia is still a very hot research area, and many questions remain about its heritability, symptoms, causes, and treatment.
Causes of Schizophrenia Disorder
Mental disorders, especially those with strong biological evidence of causation, are always highly studied areas in the realm of psychology and psychiatry. In order to discover the cause of such disorders and find indications toward appropriate treatment, we look at physiological, genetic, and social factors. Any questions into genetic influence immediately lead us into a web of complexity, especially regarding such dynamic disorders like schizophrenia and autism. Schizophrenia is a fascinating disorder, still provoking an abundance of questions, despite the mounds of literature accumulated on the topic. It seems that although research points to strong genetic influence, schizophrenia is still classified as a psychotic disorder, and as such, its expression is dependent on both a genetic pre-disposition coupled with an environmental trigger. In psychology, when an individual’s biological disposition meets his or her personal environment, certain conditions may arise and disorders of ambiguous cause are formed, therefore reviving the age old question: Is it nature, or is it nurture?
Monozygotic twin, fraternal twin, and adoption studies have been performed in order to give researchers a better understanding of the level of influence genetics and environment have on individuals who are diagnosed with schizophrenia. These studies look at equal environment and gene sharing situations, as in the case of monozygotic twins; Equal environment and partly shared gene situations , as in the case of fraternal twin studies, and equal-gene and different environment sharing situations, as in the case of adoption studies.
The importance of these studies is that they indicate that schizophrenia is largely genetic. Even in cases in which children with a pre-disposition for the disorder are adopted, they are still likely to develop the disorder, especially if someone in their biological family expressed active symptoms. The risk of such pre-disposed individuals increases according to how many genes they share with their biological relative and how severe that person’s symptoms were. It is important to note however, that unstable environments or different physical or social experiences can cause an early expression of the disorder.
Other theories exist thanks to research into anti-psychotic medications used to treat some symptoms of schizophrenia. Neuroleptics are often used to treat positive symptoms of schizophrenia and they work by blocking dopamine receptor sites. Therefore, one theory about the cause of schizophrenia focuses on neurobiological influences, specifically the excess of the neurotransmitter dopamine. It is speculated that individuals who suffer from schizophrenia have high levels of active dopamine. This can be tied to genetics by theorizing that the coding of dopamine production is passed on through genes.
Another theory about the cause of schizophrenia looks at the neurological composition and function of individuals suffering from schizophrenia and those at high risk of developing the disorder. Research about the brain structure of these individuals reveals slight neurological abnormalities, especially evident in attention, reaction-time, and reflex studies.
Symptoms of Schizophrenia Disorder
As we’ve touched on vaguely, the symptoms of schizophrenia compromise a wide spectrum of cognitive, emotional, behavioral, and to a lesser extent, physical symptoms. Schizophrenia is mainly divided into two categories of symptoms: Positive and Negative.
Positive: The range of symptoms classified as ‘positive’ are the most visibly noticeable, dysfunctional symptoms. The expression of these types of symptoms are what usually precede a diagnosis. Additionally, a schizophrenic with mostly positive symptoms may be diagnosed with a more severe type of schizophrenia. However, positive symptoms are mostly treatable with antipsychotic medications which have been shown to reduce the amount of hallucinations, delusions, and ‘magical thinking‘ symptoms.
Negative: The range of symptoms classified as ‘negative’ are often missed or misdiagnosed as they are expressed in behaviors that resemble depression such as social isolation, flat affect, decreased motivation, and inability to express emotion. Negative symptoms of schizophrenia may be treated to some extent with anti-depressants, but these types of symptoms are trickier to treat than positive symptoms.
Treatment of Schizophrenia Disorder
Since schizophrenia is a tremendously complex disorder, having both biological and environmental roots, it is necessary that the treatment of the disorder reflect this complexity. Since the early days, schizophrenia has been treated to some degree in both a biological and psychosocial manner. Although removing parts of the victim’s brain and using electroconvulsive therapy have both been used as biological treatments of the condition, some (however, very few) physicians recognized the need to treat the patient with care and patience, even during medieval times. Today, we recognize that schizophrenia can be treated both biologically and socially, which is why we try to treat the symptoms according to classification. For example, individuals suffering from mainly positive symptoms will most likely be treated through psychopharmacology which combines antipsychotic medications with anti-depressants. This approach seeks to treat the entire spectrum of the disorder by using a different medication for each class of symptom. Other treatments seek to educate family and community about the implications of schizophrenia and seeks to provide the suffering individuals with support and compassion.