Schizophrenia is a mental illness that is characterized by a severe disabling brain disorder that becomes chronic in some cases. A person with this disorder often changes his behavior, perception and thinking such that they become disoriented from their sense of reality. Much stigma is associated with schizophrenia due to the changes in behavior that occur once the disease strikes. A person with schizophrenia may get delusional whereby they acquire false beliefs of guilt, special powers, persecution and, they may keep on feeling like other people are plotting evil against them (Larry, 2003). These people may also get hallucinations such that they keep on hearing, seeing, smelling or sensing things that in reality do not exist. In most cases, the sick person exhibits thought disorders whereby their speech does not consist of any logical flow. In addition, a person suffering from schizophrenia may lack drive, concentration, emotion, insight, and social skills.
Schizophrenia is a mental illness that has been considered for thousands of years. In the beginning, doctors and psychiatrists did not differentiate the different types of mental disorders and all of these illnesses were treated in the same manner. German physician, Emil Kraepelin was among the first people to categorize mental illnesses into different types such as ‘dementia praecox’ that can be associated with schizophrenia (Kim, 2011). In the subsequent years, physicians and psychiatrists continued to study different symptoms for different mental disorders, and they even categorized various types of schizophrenia. This breakthrough refuted the early beliefs that schizophrenia was caused by evil spirits, a misconception that had made people to use dangerous means of exorcising the sick.
The following paper describes the biological theories concerning schizophrenia (one of the most devastating of all psychological disorders), affecting about one percent of the total population. The paper will also explain the biological therapies that exist and show how effective these therapies are in handling schizophrenia.
Current Biological theories concerning Schizophrenia
Although it has proved difficult to identify the exact causes of schizophrenia, several factors have been cited to contribute to this mental disorder. The theories could be physical, genetic, psychological and even environmental. In this paper, the focus is inclined towards the biological factors that may trigger psychotic episodes in schizophrenia cases. The biological theories seem to focus on structural, functional and genetics aspects of the brain abnormalities.
Genetic factors
There exists strong evidence that genes contribute to the risk associated with schizophrenia. Schizophrenia occurs in families, and research shows that various combinations of genes may make people more vulnerable to the disorder. A study done on twins brought up separately revealed that genes contribute to development of schizophrenia though genetic components are not the only factors that may lead to this disorder. Genes do play a major role in the transmission of the disorders, and the risk of developing the disorder is high in two categories of relatives. These two classes of people are those who share a considerable number of genes such as a child borne of two schizophrenic people and monozygotic twin of a schizophrenic person. Studies shown by Gottesman and Shields revealed that cases of schizophrenia in monozygotic twins ranged from 35- 58% as compared to dizygotic twin that ranged from 9- 26%, assuming that the shared environmental factors were equal (Kim, 2011). A study done on adopted persons showed that the prevalence of the disorder was exclusively in their biological relatives but not in the adoptees.
Brain development
Structure of the brain together with the any changes that affect the distribution of brain cells can lead to schizophrenia. In most cases, schizophrenia affects people who are in adolescence and adulthood due to the fact that brain develops throughout childhood and adolescence. Larry (2003) cited that synaptic eliminations that occur during adolescence may result into psychotic disorders. Furthermore, studies suggest that the long latent time between cerebral insults and the occurrence of schizophrenia may explain how levels of brain maturation may lead the disorder. There has been a connection between hormonal maturity in young people and the appearance of schizophrenia. This explains why psychiatrists and other doctors believe that structural maturity of the brain is a major factor in the development of schizophrenia during puberty and old age.
Neurotransmitters
Neurotransmitters refer to chemicals used to carry signals or messages across various brain cells. The major types of neurotransmitters that usually play a role in the onset of the disorder are dopamine, serotonin and glutamate (Maddux, 2005). Over activity of dopamine is thought to be concerned with this mental disorder due to several reasons. One of the reasons is that medication that reduces dopamine in the brain usually brings out positive results in patients with schizophrenia. Also, any drug that adds more dopamine to the brain leads to an increase in psychotic signs of the disease. It has been suggested that dopamine exhibits a high level of activity in early adulthoods that could explain the period of appearance of schizophrenia. In addition, 5-HT (serotonin) is a chemical thought to be a contributing factor to schizophrenia since the hallucinogen LSD is usually a 5-HT agonist (Maddux, 2005). In most cases of schizophrenia, the patient shows a low level of 5-HT2A receptors and a high level of 5-HT1A receptors. An imbalance between serotonin and dopamine may cause schizophrenia. A dysfunction of glutamate is also thought to be involved with schizophrenia especially in its interaction with dopamine.
Viral Infections
Research shows that there is a connection between viral infections and the onset of schizophrenia. Studies done have revealed that people who are exposed to viruses during their development have high chances of getting schizophrenia. For example, persons born in the months of winter tend to be at a high risk of contacting viral infections that may lead to schizophrenia. Mothers who are exposed to influenza virus had a high risk of getting children who suffered from schizophrenia. The same thing happens with other viral infections such as polio and flu virus. Schizophrenia was characterized by viral infections that occurred in the second trimester of fetal development. This is because this stage of development is very crucial and any disruption in brain growth may lead to the mental disorder (Noll, 2007).
Pregnancy and its related complications
Pregnancy and birth complications may lead to high chances of getting schizophrenia later in life. Abnormal growth of the baby while in the womb may lead to a risk in acquiring the mental disorder. Abnormalities may have been caused by malnutrition, prematurity, hypoxia or ischemia during pregnancy (Kim, 2011). Such abnormalities usually result in reduced levels of oxygen, nutrients and other minerals that are crucial for the development of CNS. Obstetric complications such as asphyxia or unavoidable CS have also been termed as causes of development of this mental disorder. Other factors related to pregnancy such as bleeding, preeclampsia or gestational diabetes is thought to increase the chances of getting schizophrenia later in life.
Head and brain injuries
In some cases, traumatic head injuries can be said to cause an increased likelihood of acquiring psychotic signs such as schizophrenia- like symptoms. Although schizophrenia seems to be a complex condition altogether, scientists suggest that brain injury may directly cause the disorder. In case a head injury is serious and leads to an impact on the areas of the brain that have control functions, this may lead to development of mental illness such as schizophrenia. People may be aware of the fact that brain injury may lead to psychiatric or neurocognitive illnesses but they do not understand the trend that relates head injury and schizophrenia.
Triggers
Various triggers of the brain may lead to the occurrence of schizophrenia among the people. Stress levels may psychologically trigger schizophrenia through various factors such as loss of job, bereavement, divorce, separation or abuse (sexual, emotional, physical). These kinds of experiences do not necessarily cause schizophrenia but may increase the chances of its development in those people who could already be vulnerable to it. Moreover, drug abuse is a trigger that may not necessarily cause schizophrenia but may increase the risk of development of various mental illnesses. Some of the drugs that could trigger schizophrenia are cocaine, cannabis or amphetamines especially if they are used by people who are already vulnerable or susceptible to the mental disorder. Three studies already show that young people who start using cannabis during their early years may develop schizophrenia by the time they are 26 years of age (Glenn, 2004). This is because these drugs (cocaine, amphetamines) can cause psychosis, and unfortunately may lead to relapse in patients already recovering from past effects.
Biological therapies that exist
Schizophrenia may not have prevention or cure, but a patient can get a comprehensive treatment program that can significantly reduce the symptoms and assist in maximizing quality of life (Noll, 2007). Just like other serious diseases, early diagnosis can help in minimization of the disease by giving the patient a chance to access the required biological and psychosocial treatments. A patient can be treated through an outpatient system in a hospital, but in case the illness is severe, hospitalization may be inevitable so as to stabilize the patients with acute schizophrenia. There are several antipsychotic therapies that a doctor can administer to a patient depending on the severity of the mental disorder.
Convention Antipsychotic Therapy
Conventional antipsychotics have been in the market since 1950s. Their mechanism works in such a way as to affect the brain in order to make it work in a different way. Types of conventional antipsychotics are haloperidol, chlorpromazine and fluphenazine. They usually work by increasing the number of neural connections in the brain, and also multiply the number of support brain cells that are concerned with emotion and behavior. In the beginning, the patient may not seem to respond to the treatment since these drugs are long acting and symptoms may take time to disappear. These drugs are not usually among the mostly used by physicians since they consist of serious side effects that may or may not be reversible.
Atypical Antipsychotic therapy
These drugs are more preferred as compared to the conventional antipsychotics as seen most treatments by physicians. They were developed in the 1990s by scientists who wanted to come up with a newer version of the earlier antipsychotic medicines. Glenn (2004) believes that atypical antipsychotics had a great advantage since they consisted of mild side effects as compared to the conventional ones (the conventional antipsychotic drugs had been causing disorders such as tardive dyskinesia that was irreversible in some cases). These drugs include clozapine, aripiprazole, risperidone and olanzapine. It is not very clear as to how different their mechanism in the brain is as compared to the conventional antipsychotics. Some of the side effects associated with atypical antipsychotics are diabetes and agranulocytosis, and this is the reason as to why patients using these drugs need to have their blood checked regularly.
Antidepressants Therapy
Some of the antidepressants used in the treatment of schizophrenia work by reducing the negative symptoms exhibited by the patient. Negative symptoms may include loss of interest in daily duties and lack of emotional functionalities. The antidepressants usually assist in improving the level of goal-directed functions and an increased emotional functionality. Antidepressants used in the treatment of schizophrenia include serotonin inhibitors and fluoxetine which work by improving the negative symptoms
Effectiveness of the biological therapies
A large majority of people show improvements when treated with antipsychotic drugs. This shows that these drugs are substantially effective in treatments of schizophrenia symptoms. The most treatable symptoms are delusions and hallucinations. Some symptoms such as emotional expressiveness are hard to treat and some drugs may lead to increased symptoms that are difficult to treat. Sometimes, lowering the dosage or changing the type of drug may in turn reduce the symptoms. Some patients who are taking antipsychotic drugs may become depressed and the best way to alter the depression symptoms would be to use an antidepressant medication. Sometimes people may worry about getting addicted to the drugs that a patient is using but scientists say that antipsychotic drugs do not become addictive to the users. Furthermore, these medicines do not alter people’s free will, and patients and their families should understand and remove that misconception from their minds. The main purpose of these drugs is to assist in normalizing biological imbalances that cause the mental disorder (Glenn, 2004). For example, drugs such as haloperidol just block dopamine in a bid to reduce positive symptoms of schizophrenia. The conventional antipsychotics are very effective in controlling delusions and hallucinations. Some of the side effects may be mild such as blurred vision, dizziness or dry mouth, and most of such effects usually disappear within a few days or weeks. Some of the serious effects include reduced muscle control, cramps in the head, tremors or shuffling of legs. Prolonged usage of the antipsychotic drugs may lead to thrusting of the tongue, panting and facial ticks.
Conclusion
The paper has described the schizophrenia disease, the biological basis and therapies involved in the mental illness. Research has been very clear in explaining most of what early physicians and doctors thought was a mystery. People have come to understand that there are biological theories behind the disorder. Currently, the Clinical Brain Disorders department of the National Institute of Mental Health continues to study the molecular issues concerned with patients suffering from schizophrenia. It is good to note that genes, brain developments, pregnancy, neurotransmitters, brain injuries, triggers and viral infections may have a role to play in the development of schizophrenia. Moreover, various biological therapies exist in form of antipsychotic drugs and antidepressants that treat the symptoms of schizophrenia.
References
Glenn, S. (2004). Understanding and treating schizophrenia: contemporary research, theory, and practice. New York: Taylor & Francis Group. Pp. 67- 168
Kim, T. & Dilip, V. (2011). Clinical handbook of schizophrenia: Biological theories. New York: Guilford Press. Pp. 25- 33
Larry, D. (2003). Living outside mental illness: qualitative studies of recovery in schizophrenia: Qualitative studies in psychology. New York: New York University Press. Pp. 120-145
Maddux, J. & Barbara, W. (2005). Psychopathology: foundations for a contemporary understanding. New York: Taylor & Francis Group. Pp. 20- 35
Noll, R. (2007). Facts on File library of health and living: The encyclopedia of schizophrenia and other psychotic disorders. New York: InfoBase Publishing. Pp. 100- 143
