10.1 Schizophrenia

Schizophrenia is the most important and most terrible of all mental illnesses.

  • By some estimates, about 1% the world’s population suffer from schizophrenia
  • about 50% of the beds in mental hospitals are occupied by schizophrenics.
  • It is NOT multiple personality disorder
  • From the greek “split” and “mind”: a loss of touch of reality

Positive symptoms

  • hallucinations
  • delusions
  • disorganized speech
  • disorganized behaviors

Negative symptoms

  • absence of normal cognition

Subtypes of schizophrenia

  • paranoid: delusions of persecution
  • catatonic: unresponsive to surroundings, purposeless movement, parrot-like speech
  • disorganized: delusions and hallucinations with little meaning, disorganized speech, behavior and flat effect
  • Undifferentiated: others that are hard to classified

The basic psychological malfunction

  • inability to sequence and coordinate thoughts and perceptions
  • further problems arise from loss of contact with others

The basic neural malfunction

  • too much dopamine (but it is not that simple): studies of schizophrenia find abnormally high dopamine activity. One reason to believe this is that anti-psychotic drugs have some beneficial effect on schizophrenia and they work by blocking dopamine reception at the synapse so dopamine doesn’t work as well.
  • It’s also supported by the fact that if somebody who’s not schizophrenics takes a lot of amphetamines, you sometimes get amphetamine psychosis, which is a lot like schizophrenia.
  • it is not that simple
    • if it was really caused by an excess of dopamine, anti-psychotic drugs should work for everybody, but they don’t.
    • there are structural abnormalities in the brain that can’t be accounted for by this dopamine hypothesis.
    • There’s been a lot of studies on the heritability of schizophrenia, and there’s a powerful role of genetics. A close biological relative has schizophrenia, your increase in likely to have it yourself. In fact, if your identical twin has it, you’re about 50 percent likely to have it. But it is not 100%.
    • environmental triggers
      • difficult birth
      • some potential viral infections
      • more schizophrenics are born in the winter than in summer
      • Then later in life, it may be due to stress-producing circumstances or a difficult family environment, and in fact, schizophrenics report more of these than non-schizophrenic. But, it’s a complicated problem to determine cause and effect here. For instance, it might be that schizophrenics early on are showing schizophrenics symptoms which leads to more difficulties in the families or more stressful environments, it also might mean that people who know they have mental illnesses are more prone to remember bad events.