Analyze The Role Of Genetics In Schizophrenia

Schizophrenia can be slow in development where an individual does not know that he/she has been suffering from the condition for long and in some cases, it can develop suddenly.

The signs and symptoms are often difficult to distinguish from other similar mental disorders.

There are many indications shown by individuals who have schizophrenia.

These signs are difficult to recognize in teenagers. A few symptoms include:

• Disorganized speech as a result of chaotic or cluttered thinking
• Delusions or false beliefs of events or incidences that may have occurred or not occurred at all
• Frequent episodes of hallucinations
• Abnormal motor behavior including abnormal postures, lack of responses, resistance to instructions that are given
• Sleep disturbances
• Fall in academic performance in teenagers

Schizophrenia can strike without a warning.

It is also often diagnosed late as it is mistaken for other mental disorders with similar signs.

However, there are some early or first signs that can help detect this mental condition:

• Withdrawal from social circles
• Depression
• Lack of response and expressionless gaze
• Inability to emote, like a smile, laugh or cry
• Extreme criticism
• Overtly suspicious
• Insomnia and inability to concentrate
• Strange way of speaking

The early signs seen in children include:

• Late walking and talking
• Delay in learning a language
• Late crawling
• Abnormal motor behaviors

Like we saw earlier, diagnosing schizophrenia is often done after ruling out other conditions with similar symptoms and signs.

However, to test if a person is suffering from the condition, the diagnosis includes the following steps:

• • Physical examination: A general body examination is done to detect any other causes for the symptoms.

• • Scans and Tests: Tests are done to rule our internal conditions, if any, to rule out other disease conditions. Imaging tests like CT scan or MRI may also be done.

• • Psychiatric testing: A mental health evaluation is performed by a mental health professional to observe changes in behavior, demeanor, substance abuse, hallucinations, etc.

• • Use of diagnostic criteria like the DSM-5 scores by the American Psychiatric Association

There are new genetic tests that are being developed to determine how likely an individual is to develop schizophrenia.

These tests are currently in the initial stages, but once they are successfully launched, they can help health professionals to detect the risk and intervene much before the condition develops in a high-risk individual.

Mental disorders develop as a result of a combination of genetic, social psychological and environmental factors.

There are no specific genes or mutations that can tell you with 100% certainty that an individual will or will not develop a mental health disorder.

However, having a family member or relative with one does put you at an increased risk of developing a mental health disorder.

The International Classification of Diseases Manual-10 (ICD-10) classifies Schizophrenia into five subtypes:

• Paranoid Schizophrenia
• Catatonia
• Undifferentiated
• Residual
• Disorganized or Hebephrenic schizophrenia

However, in 2013, the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-V) changed this method of classification and brought all these subtypes into one umbrella –schizophrenia.

A person who has schizophrenia having active symptoms rarely knows that he/she is sick.

They are convinced that their hallucinations, delusions, opinions, etc. are all true and correct and refused to accept that there is something wrong with them.

The onset and course of schizophrenia are divided into three stages:

Prodromal stage

It is the initial stage of the disease, and there are barely noticeable changes in the individual in the way he/she talks or behaves.

Some minor changes include poor performance at school, withdrawal from people, becoming more, etc.

This stage occurs between 15-25 in males and 25-35 in females.

Acute Stage

This is the second stage in the course of schizophrenia.

The psychotic symptoms appear in this stage.

The symptoms that occur in this stage are known as ‘florid’ symptoms.

Recovery Stage

After the ‘florid’ symptoms of the acute stage subside, the recovery stage begins.

It often starts with the person slipping into depression when they start to comprehend the effect the disease has had on their lives.

After each active stage, the ability of the individual to function effectively reduces and so, it is essential to avoid relapses after successful treatment.

The exact cause of schizophrenia is unknown.

However, a combination of genetic, psychological, emotional and environmental factors play a role in increasing one’s risk of developing the disorder.

There are also a few triggers that can play a direct role in causing schizophrenia in people who are at risk. Two most common ones include:

Stress

• This is by far the most common trigger factor for any mental disorder, including schizophrenia.
• Events like losing a loved one, losing a job, end of a relationship, sexual or emotional abuse are some stress-causing scenarios that directly impact the psychological well-being of an individual who is vulnerable to developing schizophrenia.

Drug Abuse and misuse

• Drug or substance abuse has a direct effect on the mind.
• Drugs like LSD, cocaine, and amphetamines trigger schizophrenia in prone individuals and can cause a relapse in people with a history of schizophrenia.

The causes that trigger paranoid schizophrenia are the same as that for other types of the disorder.

Genetics, stress, drug abuse and familial history of the disease are possible to trigger factors for paranoid schizophrenia.

The two most common approaches to treat schizophrenia are anti-psychotic medications and different types of psychotherapies.

Different forms of psychotherapy are used and each has its ability to reduce or effectively eliminate the symptoms of the disorder.

These therapies include:

• Personal Therapy
• Cognitive Behavioral Therapy
• Compliance Therapy
• Acceptance and Commitment Therapy
• Supportive Therapy

Since schizophrenia is often diagnosed late, it tends to have a profound adverse effect on the patient and his/her life.

If left untreated, schizophrenia can cause emotional, physical and behavioral problems in the patient’s life.

Few complications of untreated schizophrenia include:

• Depression
• Problems in different relationships
• Problems in the family
• Social isolation
• Phobias
• Anxiety
• Substance, drugs and alcohol abuse
• Suicidal tendencies
• Death

The two pillars of schizophrenia treatment are medications and therapy.

However, a minimal number of patients are able to live a normal life without antipsychotic medications.

The reason for this is that they well-functioning individuals and can cope better with the condition.

This also reduces the side-effects anti-psychotics can have on the individual due to their long-term use.

Many studies have been conducted to determine if mental health conditions run in families.

Some disorders and conditions like schizophrenia, schizoaffective disorder and depression do run in families, and if someone in your family suffers from any of these, the other members are at risk of developing the same.

Some of these are due to your genes. However, the chance of not developing a mental health condition is higher than the possibility of developing it.

Having said that mental health disorders run in families, the next logical question that comes to mind is will you develop one if you have no familial history.

The answer to this lies in the understanding of how one develops schizophrenia.

Schizophrenia develops as a result of genetic predisposition and environmental factors that affects a child’s mind either during pregnancy, birth or in early childhood.

Additional factors later on in life can further aggravate an already vulnerable or susceptible individual.

So, even if no one in the family has schizophrenia, one can develop it due to environmental and psychological causes later in life.

As mentioned above, no one is born with schizophrenia.

It is a condition that develops as a result of a combination of genetic, psychological, environmental and social factors.

Schizophrenia has a definite genetic component that predisposes one to an increased risk of developing the disease.

Having a relative or a family member with the genes can put one at an increased risk of developing the condition.

However, though some genes increased the likelihood of one developing the condition, no gene takes full responsibility for the pathology.

The genetic risks associated with schizophrenia are due to Single Nucleotide Polymorphisms(SNPs) and Copy Number Variants (CNVs).

Both of these act as risk factors but are not the only cause for one developing schizophrenia.

Many studies have been conducted to detect the genetic aspects of schizophrenia.

According to the researchers at UCL genetics institute, gene variations that prevent the neurotransmitter receptor N-methyl-D-aspartate receptor (NMDAR) from functioning correctly cause schizophrenia.

NMDAR is a protein that carries information between the brain cells in response to the neurotransmitter glutamate.

There are three genes that code for this NMDAR- GRIN1, GRIN2A, and GRIN2B.

A fourth one FYN codes for a protein called Fyn that controls NMDAR functioning. Mutations in any of these genes are said to cause schizophrenia.

Vitamin B supplements have shown significant success in treating schizophrenia cases. The vitamin B types that are helpful include:

• Thiamin(B1)
• Niacin(B3)
• Pyridoxine(B6)
• Folate(B9)
• Cobalamine(B12)

The benefits of using magnesium in treating various mental health conditions, including schizophrenia, is promising.

Magnesium supplements induce rapid recovery from depression, calm the nervous system, both of which are helpful in schizophrenic patients.

Treatment for schizophrenia is multi-fold and diet and nutrition are a part of the paradigm.

They tend to improve the effectiveness of other treatments given and reduce the adverse effects of the medications.

Few things in the diet that can help cure schizophrenia include:

• Avoiding excessive intake of carbohydrates and stimulants
• Increasing the intake of essential fats
• Increasing the consumption of antioxidants makes a huge difference
• Including foods that are rich in all types of vitamin B
• Increasing intake of zinc

People with schizophrenia often have high levels of inflammatory chemicals in their body, but low levels of omega-3 fatty acids in their blood.

The omega-3 fatty acid is commonly found in fatty fish and walnuts. Increase the intake of Omega-3 fatty acids will also be beneficial.

Aerobic exercise therapy is very useful in treating patients with schizophrenia.

Regular aerobic exercises are said to increase the individual’s ability to understand and function according to researchers at the University of Manchester.

Aerobic exercises like cycling, treadmills, etc. also improve the cognitive functioning in patients.

Yes. Schizophrenia can develop when a person who is susceptible to the disorder biologically is exposed to environmental factors such as high stress, drug or substance abuse, and alcohol abuse.

It is also triggered in teenagers and young adults when their bodies are undergoing hormonal and physical changes.

Men tend to develop schizophrenia at an earlier age than women.

While men develop the disease between 16-25 yrs of age, women tend to develop it after 30.

The average age of onset of the disease is 18 for men and 25 for women.

Schizophrenia makes it difficult for people to be loving, caring and form close personal bonds and maintain relationships.

These individuals tend to socially aloof and can appear distant and cold.

However, most people who develop schizophrenia were healthy when they got into relationships.

Even though the personality of individual changes due to the condition, relationships can survive when both partners get the right kind of support.

About 70% of schizophrenic patients experience hallucinations of various types – visual, auditory, tactile or olfactory.

Visual hallucinations include seeing things– people, events, objects, lights, etc., that are not present.

Perception gets altered and leaves the person with an inability to judge distances as well.

Auditory hallucinations include hearing voices; instructions sound like whispering or murmuring that are non-existent.

These voices can make the individual do some dangerous tasks that can cause injury or death.

Tactile Hallucinations include the feeling that they have been stabbed, wounded, hurt, or something is crawling up on or inside them, whereas in real life they are fine and safe.

Olfactory hallucinations include smelling things that are not existent.

Psychotic break means losing contact with reality, hearing, seeing feeling or smelling things that are non-existent, having hallucinations and delusions, unable to comprehend things happening around, having disorganized thoughts, all of which are seen in patients with mental disorders.

One cannot just burst into a ‘psychotic break’ and snap right out of it.

This is a complex, ongoing event that needs to be treated using combination therapy to cure the individual of the disorder altogether.

Alcohol and drug abuse are considered to be high-risk factors for developing mental disorders, including schizophrenia.

If a person suffering from schizophrenia drinks alcohol, his/her condition can deteriorate and can make the disease worse.

While no one is born with this condition, all patients before the disease sets in have average intelligence.

However, at the onset of disease, the different lobes of the brain like the frontal and temporal lobes become impaired or malfunction due to which most schizophrenic patients lose their cognitive abilities, their ability to reason, comprehend and organize their thoughts.

As a result of this, they tend to score low on IQ or other intelligence tests.

The answer to this question is based on the severity of the individual’s illness and symptoms.

A person with harmless hallucinations and delusions finds it more comfortable to join the workforce as compared to someone who has negative symptoms.

Cognitive deficit problems are also a hindrance for someone who wants to work.

However, schizophrenic patients who are under treatment and respond positively to it, find being functional helpful for their therapy.

Individuals with DID tend to have multiple personalities that come out at different times.

However, in schizophrenia, the patients have no multiple personalities.

The disorder is characterized by hallucinations and delusions where people see or hear things that are not real.

The rate of suicide attempts is higher in patients with DID than in patients with schizophrenia.

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