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Schizophrenia is a brain disease
1. What is schizophrenia
Schizophrenia is a brain disease that usually begins between the ages of 17 and 25. Characteristic symptoms of this mental disorder are hallucinations - when the patient hears voices or sees objects that other people cannot hear or see - and various shapes delirium, i.e. expressing untrue ideas, such as that someone is trying to harm him or putting bad thoughts into his head.
People with schizophrenia may talk strangely and do meaningless things. They may withdraw from normal activities, such as going to school, going to work, or socializing with friends, and instead become lonely, withdrawing from contact with other people, or sleeping for long periods of time. Such patients may neglect the rules of personal hygiene.
A patient with schizophrenia behaves differently in many ways than before the illness, but these are not two different people, and his personality is not split.
2. What are the causes of schizophrenia
Currently, scientists do not know the causes of schizophrenia, and one hypothesis is that some people are born with the condition. Some researchers believe that schizophrenia may be caused by a virus that infects the brain of an unborn fetus. Others believe that stress, which may result from the most various situations, such as: studying at school, work, love conflicts, the birth of a child, etc. Schizophrenia is allowed in persons predisposed to it. There is, however, no evidence that schizophrenia is caused by difficult family relationships or poor parental attitudes towards the child.
3. What is the probability of getting schizophrenia?
For each individual person The likelihood of developing schizophrenia is low. If there are no family members with schizophrenia, the chance of not getting schizophrenia is 99 out of 100. For a person whose brother or sister has schizophrenia, the chance of not getting sick is 93 out of 100.
If one of the parents suffers from schizophrenia, the child’s chance of getting the disease is 10-12%. In cases where both parents suffer from schizophrenia, the likelihood of the child developing this disease increases to 46%.
Many patients with schizophrenia family life And love relationship are shaping up quite well. People with schizophrenia can also be good parents. Despite this, many people with schizophrenia believe that they should not have children. They know that raising children is a stressful experience and that children do not tolerate separation from their parents, who sometimes have to be hospitalized for treatment of schizophrenia.
4. How is schizophrenia treated?
Medicines are the main treatment for schizophrenia. These include such well-known drugs as Halopiridol, Orap, Semap, Triftazin, Tizercin, and others. These drugs help correct strange behavior in patients, but may also cause side effects such as drowsiness, hand tremors, muscle stiffness, or dizziness. To eliminate these side effects you have to use the drugs Cyclodol, Akineton. Drugs such as Clozapine cause fewer side effects, but regular blood tests are required when taking Clozapine. Recently, new generation drugs have appeared, such as Rispolept, which have a minimal number of side effects, which can significantly improve the quality of life of patients.
Assistive psychotherapy and counseling are often used to help a person with schizophrenia. Psychotherapy helps people with schizophrenia feel better about themselves, especially those who experience irritation and feelings of worthlessness as a result of schizophrenia, and those who tend to deny the presence of this disease. Psychotherapy can equip the patient with ways to deal with everyday problems. Currently, most schizophrenia specialists believe that in the process of psychotherapy, one should avoid looking for the causes of schizophrenia in childhood events, as well as actions that awaken memories of bad events of the past.
Social rehabilitation is a set of programs aimed at teaching patients with schizophrenia how to maintain independence, both in a hospital setting and at home. Rehabilitation focuses on teaching social skills to interact with others, skills needed in Everyday life, such as keeping track of your own finances, cleaning the house, making purchases, using public transport and so on., vocational training, which includes activities necessary to obtain and maintain employment and continuing education for those patients who want to graduate from high school, attend college, or graduate from college; Some patients with schizophrenia successfully obtain higher education.
A day treatment program consists of some form of rehabilitation, usually as part of a program that also includes drug therapy and counseling. Group therapy aims to solve personal problems, and also allows patients to help each other. In addition, social, recreational and work activities are provided as part of the day programs. The day treatment program may be based in a hospital or mental health center, and some programs provide housing for patients discharged from the hospital
In addition to participating in many activities of the day treatment program, psychosocial rehabilitation centers offer mental health patients membership in a social club. It should be remembered, however, that such programs do not provide for drug treatment or counseling and that they are not usually affiliated with a hospital or local mental health center. Their main goals are to provide patients with a place where they can feel at home and to teach job skills that prepare social club members to perform specific job responsibilities. Such programs often involve patients living in “collective” houses and apartments.
Recreation centers, which are not usually part of a treatment program, play a very important role in improving the lives of people with schizophrenia. Some of these centers are owned by mental health associations, and many are run by clients, i.e. people who themselves suffer mental disorders. Leisure centers are usually open for a few hours during the day or evening to enable people with schizophrenia or other mental disorders to spend time with a group of friends and take part in social or recreational activities.
5. How people with schizophrenia can help themselves
Take medication. 7 out of 10 patients will relapse (disease symptoms appear again) and may even require hospitalization if they do not follow the doctor's prescribed medication regimen. Patients should tell their doctors which medications work best for them and be open with their doctors about any side effects.
Do not drink alcohol or drugs. These substances can also cause a relapse or worsen the symptoms of schizophrenia. Alcohol and drugs are harmful to the brain and make recovery difficult.
Monitor for signs of impending relapse. Bad dream, irritability or restlessness, difficulty concentrating, and a feeling of your head being filled with strange thoughts are signs of a return of schizophrenia. Patients should report these warning signs to family members and doctors.
Avoid stress. Coping with stress is difficult even for healthy people. In some patients, stress can worsen schizophrenia. Patients should avoid activities or situations that cause them tension, irritation or negative emotions. Running away from home or walking on the road is not a cure for schizophrenia and may, in fact, make the condition worse.
Control your behavior. Most people with schizophrenia are not violent and do not pose a danger to other people. Some patients, however, feel worthless and think that other people treat them badly because they have schizophrenia. They may become irritable and take their frustration out on other people, sometimes family members who are trying to help them. It is important that people with schizophrenia understand that they are no worse than other people, and follow generally accepted rules of everyday communication with other people.
Use your abilities and talents. People with schizophrenia must do everything possible to recover. These are often intelligent and talented people, and even despite strange thoughts, they should try to do what they have learned before, as well as try to acquire new skills. The participation of such patients in treatment and treatment is important. rehabilitation programs, as well as pursuing their professional activities or continuing their education to the extent possible.
Join groups or become members of clubs. Joining a group or club that matches the patient's interests, such as a church or music group, can make life more varied and interesting. Participating in therapy groups, support groups, or social clubs with others who understand what it is like to be mentally ill can improve the condition and well-being of patients. Client or consumer groups led by hospitalized patients help other patients feel supported, included, and understood about their problems, and increase their ability to participate in recreational activities and public life. Some groups also provide legal assistance to their members.
6. What help can the family provide to the patient?
Try to learn more about this disease. Family members behave more appropriately if they are sufficiently aware of schizophrenia and its symptoms. Knowledge helps them to correctly relate to the strange behavior of the patient and more successfully cope with the problems arising due to this disease. The necessary information about schizophrenia and modern methods of its treatment can be obtained from support groups, medical workers or learn from modern books.
Know what to expect from the patient. A person with schizophrenia usually needs long-term treatment. During treatment, symptoms may come and go. Family members should know what to expect from the patient in terms of doing household chores, working, or socializing with others. They should not require a patient who has just left the hospital to immediately begin work or even look for work. At the same time, they should not overprotect their sick relative, lowering the requirements for him. People with schizophrenia cannot stop hearing voices just because someone told them not to hear them, but they are able to keep themselves clean, be polite, and participate in family activities. In addition, they themselves can help improve their condition.
Help the patient avoid stress. People with schizophrenia find it difficult to tolerate situations where they are shouted at, irritated, or asked to do something they are unable to do. Family members can help the patient avoid stress by following these guidelines:
Do not yell at the patient or tell him anything that might make him angry. Instead, remember to praise the patient for good deeds.
Do not argue with the patient or try to deny the existence of strange things that he hears or sees. Tell the patient that you do not see or hear such things, but you acknowledge that they do exist.
Keep in mind that ordinary events - moving to a new place of residence, getting married, or even a holiday dinner - can make people with schizophrenia angry.
Do not become unduly involved in the problems of a sick relative. Save time for your own needs and the needs of other family members.
Show love and respect to the patient. Remember that people with schizophrenia often find themselves in unpleasant situations and sometimes feel bad about themselves because of this illness. Show through your daily behavior that your relative with schizophrenia is still a respected and loved member of the family.
Take part in your relative's treatment. Find out which treatment programs best help the patient and convince him to participate in these programs; This is also important because while participating in these programs, your relative will be able to interact with people other than their own family members. Make sure that your sick relative takes his prescribed medications, and if he stops taking them, try to find the reasons for this. People with schizophrenia usually stop taking medications because the side effects are too severe or because they consider themselves healthy and therefore not in need of medication. Try to keep in touch with your doctor and let him know which medicine works best for the patient.
7. Can the condition of patients with schizophrenia improve?
Undoubtedly! Studies have shown that the majority of patients whose symptoms of schizophrenia were so severe that they had to be hospitalized improved. The condition of many patients may become better than in given time, and nearly one third of those affected may recover and no longer have any symptoms. Groups led by former patients include people who once had very severe schizophrenia. Now many of them work, some are married and have their own home. A small number of these people have resumed their studies in college, and some have already completed their studies and received good professions. New ones are constantly being held Scientific research, and this gives reason to hope that a cure for schizophrenia will be found. Our time is a time of hope for patients with schizophrenia.
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About once a year, and sometimes a little more often, another fighter against psychiatry appears on the Internet. In general, they are very stereotypical people with a standard set of claims and a complete reluctance to read any information, much less look for it, if it does not confirm the fact that psychiatry is a pseudoscience created for the personal enrichment of psychiatrists, pharmaceutical companies and the fight against dissidents. One of the main trump cards of the fighters is the fact that people with schizophrenia turn into “vegetables” and psychiatrists with haloperidol are solely to blame for this. More than once, my colleagues, both here and in my journal, have said that the process of becoming a vegetable is inherent in the disease itself. For the same reason, it is better to treat schizophrenia than to admire the amazing and unique world sick person.
The idea that schizophrenia is associated with changes in the brain is not new. This was written about back in the 19th century. However, at that time, the main research tool was post-mortem autopsies, and for quite a long time nothing special and distinctive from all other “brain” diseases was found in the brains of patients. But with the arrival in medical practice Tomography nevertheless confirmed that brain changes occur in this disorder.
It has been found that people with schizophrenia lose cortical volume. The process of bark loss sometimes begins even before clinical symptoms. It is present even when the person is not receiving treatment for schizophrenia (antipsychotics). Over five years of illness, the patient can lose up to 25% of the volume of the cortex in some areas of the brain. The process usually begins in the parietal lobe and spreads throughout the brain. The faster the volume of the cortex decreases, the faster the emotional-volitional defect occurs. A person becomes indifferent to everything and has no desire for anything - the very thing that is called a “vegetable”.
I have a little bad news. We are constantly losing nerve cells. This is actually a natural process and it goes quite slowly, but in patients with schizophrenia this process accelerates. So, for example, normally teenagers lose 1% of the cortex per year, and with schizophrenia 5%, adult men lose 0.9% of the cortex per year, patients 3%. Generally in adolescence A malignant form of schizophrenia is very common, where in just a year you can lose everything you can, and even after the first attack this process is visible to the naked eye.
For those interested, here is a picture showing how the brain loses its cortex over the course of 5 years of illness.
In addition to a decrease in the volume of the cortex, an increase in the lateral ventricles of the brain was also found. They are enlarged not because there is a lot of water there, but because the brain structures that lie in the walls are reduced in size. And this is observed from birth.
Here are pictures of twins - the first has schizophrenia (the "hole" in the middle of the brain in the image is where the dilated lateral ventricles), the second does not have the disease.
People with schizophrenia, even before developing the disease and even before using medications, had cognitive problems, including problems with information processing and language memory. All these symptoms deepened as the disease progressed. among other things, they have a reduced (also even before the disease) function of the frontal cortex, which is responsible for criticism (i.e., correct perception of oneself, one’s actions, comparing them with the norms of society), planning and forecasting activities.
Nobody really knows for sure why this happens to the brain. There are 3 theories that have fairly strong grounds.
1. Brain development disorder. It is assumed that already in utero, something goes wrong. For example, patients with schizophrenia have some problems with substances that are very important for brain development - the same Reelin, which should regulate the process of cell movement during brain development. As a result, the cells do not reach the places where they should and form incorrect and rare connections among themselves. There are many more described mechanisms of the same type, which say that a certain congenital defect causes a disease.
2. Neurodegeneration - increased cell destruction. Here we consider cases when certain reasons, including various disorders metabolism cause their premature death.
3. Immune theory. The newest and most promising. This disease is believed to be the result inflammatory processes in the brain. Why they arise is now difficult to say reliably - maybe the body arranges it on its own (an autoimmune disease) or it is the result of some kind of infection (for example, there are facts that the flu suffered by the mother during pregnancy increases the risk of developing the disease). However, patients with schizophrenia have various inflammatory substances in the brain that can be quite aggressive to surrounding cells. About similar mechanisms, but for depression
No one claims that antipsychotics are a panacea for schizophrenia. To some extent, the situation with them now is obvious: we will no longer be able to squeeze out of them any greater benefit than we have now. It is possible to improve the safety profile of a drug, but neuroleptics do not radically solve the issue. We need some new ideas and discoveries in the field of schizophrenia, a new breakthrough in understanding the disease. The latest immune theory sounds very promising. However, at the moment, antipsychotics are all we have. These medications allow patients long time live in society, not stay within walls psychiatric hospital. Let me remind you that just less than 100 years ago, mental illness was a death sentence and treatment was limited to keeping patients in hospitals. Now only a small proportion of patients are in hospitals, and it is thanks to antipsychotics that this is possible. In fact, in practice, and any psychiatrist will tell you this, it is the lack of treatment that leads to a faster transformation into a vegetable. Destruction of the brain... it is destroyed by disease even without neuroleptics, and in some people this happens very quickly.
There are a great many questions about schizophrenia that scientists still cannot answer. But first, let's talk about the most important thing.
Schizophrenia is a very common mental illness. Statistics show that around one in 100 people in Australia will suffer from it at some stage in their lives. Thus, almost everyone has friends or relatives with schizophrenia.
Schizophrenia is a complex condition that is difficult to diagnose, but the listed symptoms are usually identified: mental activity, perception (hallucinations), attention, will, motor skills are impaired, emotions are weakened, interpersonal relationships, streams of incoherent thoughts, perverted behavior are observed, a deep feeling of apathy and a feeling of hopelessness arise.
There are two main types of schizophrenia (acute and chronic), and at least six subtypes (paranoid, hebephrenic, catatonic, simple, nuclear and affective). Fortunately, schizophrenia is treated with cognitive therapy, but most often with medication.
There are many myths associated with schizophrenia. One of them is the point of view that this disease occurs more often in rural areas than in cities. Moreover, according to outdated information, schizophrenics from rural areas often move to cities to find privacy. However, scientists refute this myth.
A study of schizophrenia among Swedes indicates that urban residents are more susceptible to the disease and they do not move anywhere. Scientists say that the environment can push people towards illness.
But myths aside, the true source of schizophrenia is still a mystery. Previously, it was believed that the cause was the parents’ poor attitude towards the child - usually they blamed mothers who were too restrained and cold in their treatment. However, this point of view is now rejected by almost all experts. Parents are much less to blame than is commonly believed.
In 1990, researchers at Johns Hopkins University found a link between shrinkage of the superior temporal gyrus and intense schizophrenic auditory hallucinations. It has been theorized that schizophrenia results from damage to a specific area on the left side of the brain. Thus, when “voices appear” in a schizophrenic’s head, there is increased activity in the part of the brain that is responsible for thinking and speech.
In 1992, this hypothesis was bolstered by a major Harvard study that found a link between schizophrenia and shrinkage of the left temporal lobe of the brain, especially the part responsible for hearing and speech.
Scientists have found a connection between the degree of thought disorder and the size of the superior temporal gyrus. This part of the brain is formed by a fold of the cortex. The study was based on a comparison of magnetic resonance imaging of the brains of 15 patients with schizophrenia and 15 healthy people. It was found that in patients with schizophrenia this gyrus is almost 20% smaller than in normal people.
Although this work does not result in new treatments, the scientists believe their discovery provides an opportunity to “further study this serious disease» .
Nowadays, new hope arises every now and then. A 1995 study from the University of Iowa suggests that schizophrenia may result from pathology of the thalamus and areas of the brain anatomically associated with this structure. Previous evidence indicated that the thalamus, located deep in the brain, helps focus attention, filter sensations, and process information from the senses. Indeed, “problems in the thalamus and related structures, extending from the top of the spine to the back of the frontal lobe, can create a full range of symptoms observed in schizophrenics."
Perhaps the whole brain is involved in schizophrenia, and certain psychological ideas, for example about oneself, may have a certain connection with it. Dr. Philip McGuire says: "The predisposition [to hearing voices] may depend on abnormal activity in areas of the brain associated with the perception of internal speech and the assessment of whether it is one's own or someone else's."
Is there a specific time for such brain disorders to occur? Although symptoms of schizophrenia usually appear in adolescence, the damage that causes it can occur in infancy. "The exact nature of this neural disorder is unclear, but [it reflects] disturbances in brain development that appear before or shortly after birth."
There are experts who believe that schizophrenia can be caused by a virus, and a well-known one at that. A controversial but very intriguing version of the causes of the disease was put forward by Dr. John Eagles of the Royal Cornhill Hospital in Aberdeen. Eagles believes that the virus that causes polio can also influence the onset of schizophrenia. Moreover, he believes that schizophrenia may be part of the post-polio syndrome.
Eagles bases his belief on the fact that since the mid-1960s. in England, Wales, Scotland and New Zealand, patients with schizophrenia decreased by 50%. This coincides with the introduction of polio vaccination in these countries. In Great Britain oral vaccine was undertaken in 1962. That is, when polio was stopped, the number of cases of schizophrenia decreased - no one imagined that this could happen.
According to Eagles, Connecticut scientists found that patients hospitalized with schizophrenia were “significantly more likely to be born during polio years.”
Eagles also points out that among unvaccinated Jamaicans who came to the UK, "the prevalence of schizophrenia is significantly higher compared to the local [English] population."
Eagles notes: in recent years, the existence of post-polio syndrome has been established. In this syndrome, approximately 30 years after the onset of paralysis, people begin to suffer from severe fatigue, neurological problems, joint and muscle pain and hypersensitivity (especially to cold temperature). Post-polio syndrome occurs in approximately 50% of polio patients. According to Eagles, “the average age of onset of schizophrenia is approaching thirty years, and this is consistent with the concept of schizophrenia as a post-polio syndrome that develops after perinatal poliovirus infection.”
Doctors David Silbersweig and Emily Stern of Cornell University believe that schizophrenics are unlikely to have serious problems with a brain, but, nevertheless, they managed to discover something very interesting. Using PET, they developed a method for detecting blood flow during schizophrenic hallucinations. They conducted a study of six either untreated or treatment-resistant schizophrenics who heard voices. One experienced visual hallucinations. During the scan, each patient was asked to press a button with their right finger if they heard sounds. It was found that during hallucinations, superficial areas of the brain involved in processing auditory information were activated. Moreover, all patients had a rush of blood to several deep areas of the brain: the hippocampus, hippocampal gyrus, cingulate gyrus, thalamus and striatum. Do schizophrenics really hear voices? Their brain data shows that this is true.
The speech of schizophrenics is often illogical, incoherent and confused. They used to think that such people were possessed by demons. Researchers have discovered a much less fantastic explanation. According to Dr. Patricia Goldman-Rakic, a neurologist, the speech problems of schizophrenics may reflect short-term memory deficits. It has been discovered that the prefrontal cortex of schizophrenics is significantly less active. This area is considered the center of short-term memory. Goldman-Rakic says, “If they are unable to retain the meaning of a sentence before moving on to the verb or object, the phrase becomes devoid of content.”
In addition to all of the above, there are many questions about schizophrenia that are still unanswered.
Is schizophrenia caused by the mother's immune response or poor nutrition?Some scientists believe that schizophrenia is caused by damage to the developing fetal brain. A study from the University of Pennsylvania, which included medical data from the entire Danish population, found that severe malnutrition in the mother early in pregnancy, as well as her body's immune response to the fetus, may influence the onset of schizophrenia.
Thanks to the memoriesAs the body ages, the enzyme prolyl endopeptidase increasingly destroys neuropeptides associated with learning and memory. In Alzheimer's disease, this process accelerates. It causes memory loss and a reduction in active attention time. Scientists from the city of Suresne in France discovered medicinal compositions, preventing the destruction of neuropeptides by prolyl endopeptidase. In laboratory tests with rats that had amnesia, these compounds almost completely restored the animals' memory.
Notes:
Juan S. Einstein’s brain was doing the washing // The Sydney Morning Herald. 8 February 1990. R. 12.
McEwen B., Schmeck H. The Hostage Brain. N.Y.: Rockefeller University Press, 1994. pp. 6–7. Dr. Bruce McEwan is head of the Hutch Neuroendocrinology Laboratory at The Rockefeller University in New York. Harold Schmeck is a former national science columnist for The New York Times.
An interview with M. Merzenich is given by I. Ubell. Secrets of the brain // Parade. 9 February 1997. P. 20–22. Dr. Michael Merzenich is a neurologist at the University of California, San Francisco.
Lewis G., David A., Andreasson S., Allebeck P. Schizophrenia and urban life // The Lancet. 1992. Vol. 340. P. 137–140. Dr Glyn Lewis and colleagues are psychiatrists at the Institute of Psychiatry in London.
Barta P., Pearlson G., Powers R., Richards S., Tune L. Auditory hallucinations and smaller superior gyral volume in schizophrenia // American Journal of Psychiatry. 1990. Vol. 147. P. 1457–1462. Dr. Patrick Barta and colleagues work at Johns Hopkins University School of Medicine in Baltimore.
Ainger N. Study on schizophrenics – why they hear voices // The New York Times. 22 September 1993. P. 1.
Shenton M., Kikins R., Jolesz F., Pollak S., LeMay M., Wible C., Hokama H., Martin J., Metcalf D., Coleman M., McCarley R. Abnormalities of the left temporal lobe and thought disorder in schizophrenia // The New England Journal of Medicine. 1992. Vol. 327. P. 604–612. Dr. Martha Shenton and colleagues work at Harvard Medical School.
Flaum M., Andreasen N. The reliability of distinguishing primary versus secondary negative symptoms // Comparative Psychiatry. 1995. Vol. 36.No. 6. P. 421–427. Doctors Martin Flaum and Nancy Andresen are psychiatrists at the University of Iowa Clinics.
An interview with P. McGuire is conducted by B. Bauer. Brain scans seek roots of imagined voices // Science News. 9 September 1995. P. 166. Dr. Philip McGuire is a psychiatrist from the Institute of Psychiatry in London.
Bower B. Faulty circuit may trigger schizophrenia // Science News. 14 September 1996. P. 164.
Eagles J. Are polioviruses a cause of schizophrenia? // British Journal of Psychiatry. 1992. Vol. 160. P. 598–600. Dr John Eagles is a psychiatrist at the Royal Cornhill Hospital in Aberdeen.
A study by D. Silbersweig and E. Stern is presented by K. Leutweiler. Schizophrenia revisited // Science from American. February 1996. P. 22–23. Doctors David Silbersweig and Emily Stern work at Cornell University Medical Center.
Research by P. Goldman-Rakic is presented by K. Conway. A matter of memory // Psychology Today. January – February 1995. P. 11. Dr. Patricia Goldman-Rakic is a neurologist at Yale University.
Juan S. Schizophrenia – an abundance of theories // The Sydney Morning Herald. 15 October 1992. P. 14.
A study by J. Megginson Hollister et al. is cited by B. Bauer. New culprit cited for schizophrenia // Science News. 3 February, 1996. P. 68. Dr. J. Megginson Hollister and colleagues are psychologists from the University of Pennsylvania.
Sciencefi c American. Making memories // Scientific American. August 1996. P. 20.
The book by American authors outlines modern ideas about how the brain works. Issues of structure and functioning are considered nervous system; homeostasis problem; emotions, memory, thinking; specialization of the hemispheres and the human “I”; biological basis of psychoses; age-related changes brain activity.
For biology students, medical and psychological students, high school students and anyone interested in the science of brain and behavior.
Another group of data obtained as a result of post-mortem studies also confirms the idea that with some disturbances in dopaminergic synapses, the function of the latter is excessively enhanced (see Fig. 181). According to autopsy data, patients with schizophrenia have slightly increased amounts of dopamine in areas of the brain rich in this substance. In these same zones, changes were noted indicating that, along with an increase in dopamine content, sensitivity to this substance also increased inappropriately. These changes may be partly caused by chronic use of antipsychotics, however, even taking this into account, the noted changes seem impressive. Changes in the dopamine system are much more noticeable in patients who died at a young age. In general, antidopamine neuroleptic drugs give best effect when treating people over young suffering from type I schizophrenia.
However, like all partially acceptable hypotheses, this one has its own weak sides. Changes in the dopamine system, regularly noted in some studies, were not found in a number of other similar studies. In addition, dopamine serves to transmit information in many parts of the brain, so it is difficult to explain why primary changes, leading to disorders of perception, thinking and emotions, do not also manifest themselves in more obvious sensory and motor disorders. Although antipsychotic drugs cause improvement in the patient's condition in direct proportion to their antidopamine effect, other, “atypical” drugs that are not related to dopamine also give good results. Finally, in many cases of type II schizophrenia, all existing medications not particularly effective. Many brain systems appear to be involved in behavioral disorders in schizophrenia, and it remains to be seen whether the dopamine neurotransmitter system is essentially the main culprit.
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Hallucinogenic psychoactive drugs drugs, such as LSD, can cause short-term episodes of psychosis, and frequent use or overdose of marijuana and stimulants (cocaine, amphetamines) sometimes leads to transient intoxication psychosis, clinical picture which resembles schizophrenia (Bowers, 1987; Tennent and Groesbeck, 1972).
Maybe Also(although this is by no means proven) that substance abuse can trigger the onset of schizophrenia.
Relatives Patients with schizophrenia sometimes see the cause of the disorder in hallucinogens, but they are mistaken: scientific facts do not support this opinion. It is known that in Great Britain and America in the 50-60s, LSD was used as an experimental drug in psychiatry, and the percentage of individuals (among voluntary trial participants and among patients) who developed long-term psychosis such as schizophrenia almost did not exceed the corresponding figure for general populations (Cohen, 1960; Malleson, 1971).
True, carried out in Sweden A study found that military recruits who used marijuana frequently and in large quantities were six times more likely to subsequently develop schizophrenia (Andreasson et al., 1987). However, this pattern may be explained by the fact that individuals predisposed to schizophrenia were more likely to resort to marijuana use as a way to cope with premorbid symptoms of the disease.
Brain in schizophrenia
In some patients schizophrenia organic changes are detected in the brain. Post-mortem analysis of brain tissue has revealed a number of structural abnormalities, and new imaging techniques have documented intravital changes in both the structure and functioning of the brain.
With the help of such techniques Magnetic resonance imaging (MRI) has revealed changes in the size of various brain structures, especially in the temporal lobes. The fluid-filled cavities (ventricles) in the depths of these lobes are often expanded, and the volume of tissue of the lobes themselves is reduced. The greater these observed changes, the more severe the patient’s thinking and thinking disorders. auditory hallucinations(Suddath et al., 1990).
Some techniques Imaging studies such as positron emission tomography (PET) can assess ongoing brain function and provide a similar picture of abnormalities. PET scans reveal increased activity in the temporal lobes, especially in the hippocampus, a structure located in the temporal lobe responsible for orientation and ultra-short-term memory (Tamminga et al., 1992).
Building a functional Images another kind - through recording of electrophysiological parameters of the brain using an electroencephalograph - shows that most patients with schizophrenia seem to have an excessively increased response to repeated external stimuli and a more limited (compared to other people) ability to eliminate unnecessary information (Freedman et al. , 1997).
Along with this, we received data that brain structures that are thought to screen out irrelevant stimuli (e.g. frontal lobe), show reduced activity in PET scans (Tamminga et al., 1992).
Due to this difficulty screening sensory stimuli, postmortem studies of brain tissue have revealed disturbances in a certain type of brain cells—inhibitory interneurons. These neurons inhibit the activity of the main nerve cells, preventing them from overreacting a large number of input signals. In this way, they protect the brain from being overloaded with too much sensory information coming from the environment.
In the patient's brain schizophrenia the amount of “chemical messengers” or neurotransmitters (primarily gamma-aminobutyric acid (GABA)) released by these interneurons is reduced (Benes et al., 1991; Akbarian et al., 1993), which implies that the inhibitory function aimed at preventing brain overload is performed less effectively.
Deviation in the functioning of these interneurons appears to lead to changes in brain cells that release the neurotransmitter dopamine. Schizophrenia researchers have long been interested in the role of dopamine, since certain psychoactive drugs (such as amphetamines) that enhance the effects of dopamine can cause psychoses resembling schizophrenia, and psychoactive drugs that block or weaken its effects are effective in treating psychosis (Meltzer and Stahl, 1976). .
Dopamine enhances brain cell sensitivity to irritants. Typically, such heightened sensitivity is useful, increasing a person’s level of awareness of the situation during periods of neuropsychic stress or danger, but for a patient with schizophrenia, whose brain is already in a state of increased activity, the additional exposure to dopamine may be the factor that pushes him into psychosis.
Of these research Data suggests that in schizophrenia, there is insufficient regulation of brain activity by interneurons, as a result of which the brain overreacts to numerous signals coming from the environment and has insufficient ability to filter out unwanted stimuli. This problem is exacerbated by the reduction in volume temporal lobes the brain, where sensory input is typically processed; as a result, it becomes even more difficult for a person to respond adequately to new stimuli.
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