Classification and diagnosis of schizophrenia essay
A study of Finnish women supported an interaction between genetic and environmental influences on causation of schizophrenia. A new study suggests that heavy marijuana use in teenagers aged 15—17 years may hasten the onset of psychosis in those at high risk for developing a psychotic disorder. In an analysis of hospitalized patients who had experienced first-episode psychosis, the Allied Cohort on the Early course of Schizophrenia ACES II project found that the onset of psychosis in those who used cannabis from age 15 to 17 years occurred at a mean age of However, the researchers could not say whether marijuana use may actually cause psychosis to develop early or whether people who have a predilection for earlier onset of psychosis also may be more likely, owing to various factors, to use marijuana.
The onset of schizophrenia usually occurs between the late teens and the mids. The first 5—10 years of the illness can be stormy, but this initial period is usually followed by decades of relative stability though a return to baseline is unusual. Positive symptoms are more likely to remit than are cognitive and negative symptoms see Presentation.
Although some variation by race or ethnicity has been reported, no racial differences in the prevalence of schizophrenia have been positively identified. Some research indicates that schizophrenia is diagnosed more frequently in black people than in white people; this finding has been attributed to cultural bias of practitioners. The prevalence of schizophrenia is about the same in men and women. The onset of schizophrenia is later in women than in men, and the clinical manifestations are less severe.
This may be because of the antidopaminergic influence of estrogen. The prognosis is guarded. Full recovery is unusual. Early onset of illness, family history of schizophrenia, structural brain abnormalities, and prominent cognitive symptoms are associated with a poor prognosis. The prognosis is better for people living in low-income and middle-income countries. Symptoms usually follow a waxing-and-waning course and their nature may change over time. Positive symptoms respond fairly well to antipsychotic medication, but the other symptoms are quite persistent. Because of vocational difficulties, many patients with schizophrenia also have to cope with the burdens of poverty.
These include limited access to medical care, which may lead to poor control of the disease; homelessness; and incarceration, typically for minor offenses. Women with schizophrenia may have higher rates of breast cancer than women in the general population. In a meta-analysis of more than , women, this increased risk was significant in studies in which breast cancer occurred before the diagnosis of schizophrenia was excluded.
However, the association between schizophrenia and breast cancer incidence was not significant in studies that did not specify the exclusion of breast cancer cases that occurred prior to the diagnosis of schizophrenia. Researchers suggest factors such as obesity, nulliparity, and potentially even increased prolactin levels may raise the risk for breast cancer. It is important to note that significant heterogeneity exists among the included studies, and it is possible that a future study will show a decreased breast cancer risk in women with schizophrenia compared with the general population.
The nature of schizophrenia makes it a potentially difficult illness for patients to understand.
Nevertheless, teaching the patient to understand the importance of medication compliance and of abstinence from alcohol and other drugs of abuse is important. It is helpful to work with the patient so that both patient and family can learn to recognize early signs of a decompensation eg, insomnia or increased irritability.
A review of 44 studies showed that education of patients about the nature of their illness and treatment, when added to standard care, led to reductions in rehospitalization and symptoms. These groups can provide education and support. People with schizophrenia have also championed self-help recovery-based approaches to care, with an emphasis on developing the personal strengths and resilience needed to combat this illness. Because other illnesses are common in schizophrenia, education about the importance of a healthy lifestyle and regular health care is helpful.
Counseling with respect to sexuality, pregnancy, and sexually transmitted diseases is important for these patients. Mayo Clinic - Schizophrenia. National Institute of Mental Health - Schizophrenia. Medline Plus - Schizophrenia. For patient education resources, see the Schizophrenia Health Center , as well as Schizophrenia. American Psychiatric Association. Meta-analysis of regional brain volumes in schizophrenia. Am J Psychiatry.
The hippocampal formation in schizophrenia. Hippocampal volume development in healthy siblings of childhood-onset schizophrenia patients. Structural abnormalities in frontal, temporal, and limbic regions and interconnecting white matter tracts in schizophrenic patients with prominent negative symptoms.
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Ellison-Wright I, Bullmore E. Meta-analysis of diffusion tensor imaging studies in schizophrenia.
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Schizophr Res. Longitudinal volume reductions in people at high genetic risk of schizophrenia as they develop psychosis. Biol Psychiatry. Are there progressive brain changes in schizophrenia? A meta-analysis of structural magnetic resonance imaging studies.
Coyle JT. The glutamatergic dysfunction hypothesis for schizophrenia. Harv Rev Psychiatry. Cioffi CL. Modulation of NMDA receptor function as a treatment for schizophrenia. Bioorg Med Chem Lett. Immune and neuroimmune alterations in mood disorders and schizophrenia. Int Rev Neurobiol. Inflammation and schizophrenia. Expert Rev Neurother. Migration and schizophrenia.
Curr Opin Psychiatry. A meta-analysis of the risk for psychotic disorders among first- and second-generation immigrants. Psychol Med. Translating the epidemiology of psychosis into public mental health: evidence, challenges and future prospects. J Public Ment Health. Mental illness in the biological and adoptive relatives of schizophrenic adoptees.
Replication of the Copenhagen Study in the rest of Denmark. Arch Gen Psychiatry. Brooks M. New Schizophrenia Genes Identified. Medscape Medical News.
A brief history of the DSM
Jul 22 Biological insights from schizophrenia-associated genetic loci. Moderation of the effect of adolescent-onset cannabis use on adult psychosis by a functional polymorphism in the catechol-O-methyltransferase gene: longitudinal evidence of a gene X environment interaction. Genome-wide association identifies a common variant in the reelin gene that increases the risk of schizophrenia only in women. PLoS Genet. The functional GRM3 Kozak sequence variant rs affects the risk of schizophrenia and alcohol dependence as well as bipolar disorder.
Psychiatr Genet. Clinically detectable copy number variations in a Canadian catchment population of schizophrenia. J Psychiatr Res.
Copy number variations in schizophrenia: critical review and new perspectives on concepts of genetics and disease. Neurodevelopmental hypothesis of schizophrenia. Br J Psychiatry.
issues of reliability/validity associated with the classification/diagnosis of Schizophrenia (16)
Copy number variants of schizophrenia susceptibility loci are associated with a spectrum of speech and developmental delays and behavior problems. Genet Med. Confirmation and refinement of an 'at-risk' haplotype for schizophrenia suggests the EST cluster, Hs. Mol Psychiatry. Replication of 1q42 linkage in Finnish schizophrenia pedigrees. DISC1 association, heterogeneity and interplay in schizophrenia and bipolar disorder. A primate-specific, brain isoform of KCNH2 affects cortical physiology, cognition, neuronal repolarization and risk of schizophrenia.
Nat Med. Strong evidence for association between the dystrobrevin binding protein 1 gene DTNBP1 and schizophrenia in parent-offspring trios from Bulgaria. Disease-specific changes in regulator of G-protein signaling 4 RGS4 expression in schizophrenia. Confirming RGS4 as a susceptibility gene for schizophrenia.
Association and linkage disequilibrium between a functional polymorphism of the dopamine-2 receptor gene and schizophrenia in a genetically homogeneous Portuguese population. A highly significant association between a COMT haplotype and schizophrenia. Am J Hum Genet. Association of neuregulin 1 with schizophrenia confirmed in a Scottish population.
Expanding the range of ZNFA variants conferring risk of psychosis.