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What Causes Schizophrenia?

Medically reviewed by Sandeep Dhanyamraju

In the development of schizophrenia, both biological and socio-psychological factors are important.

Biological reasons include, for example, genetic abnormalities and heredity. This disease does not result from the breakdown of any one gene, but there are many genetic disorders that most often accompany this disease. “Candidate genes” are already well known to scientists. But there is no unambiguous and consistent relationship “there is a breakdown – there is a disease”. On the one hand, some patients do not have a single sick relative. On the other hand, even if both parents suffer from schizophrenia, the risk that the child will have it is only 40%. If only one of the parents is sick, it is even less – 6-10%. This is much higher than the average for the population (in general, the incidence is 0.7-0.8%, 7-8 people out of a thousand), but still too little to talk about a direct relationship.

 

In addition to heredity, biological factors include the consequences of drug use, including the 

  • lungs, 
  • complications of pregnancy and childbirth, 
  • infections in early childhood,
  • previous infections, for example, viral encephalitis. 

Social and psychological factors can also have an impact. One of the most significant is family relationships. American anthropologist Gregory Bateson concluded that “double communication” in the family is becoming a significant prerequisite for the development of schizophrenia. It is known that words are not the only way to convey information. For one reason or another, some parents transmit multilevel messages to their children. For example, the father verbally praises his son for his success in the chess club but non-verbally demonstrates contempt and disappointment that the boy did not go to the football section. Children do not ask again in such cases and are left alone with this conflicting information. It is these situations that can become one of the reasons for the development of schizophrenia.

 

Phases of Schizophrenia

  1. In the prodromal phase, individuals may not show symptoms or may have mild impairment of social adaptation, mild cognitive disorganization or perceptual distortion, decreased ability to experience pleasure (anhedonia), and communication problems. Such signs can be mild and detected only retrospectively, or they can be more pronounced and manifest as violations of social, educational, and professional activity.
  2. During an advanced prodromal period, subclinical symptoms may appear as withdrawal or isolation, irritability, suspicion, unusual thoughts, distorted perception, and disorganization. The onset of schizophrenia (delusions and hallucinations) can be sudden (over several days or weeks) or slow and imperceptible (over several years).
  3. During early psychosis, symptoms are active and, in most cases, very severe.
  4. At the intermediate stage, symptoms can be episodic (with a clear exacerbation and remission) or persistent. In this case, the functional deficit gradually increases.
  5. During the advanced stage of the disease, the disease pattern stabilizes, but there are many variations: the disorder can stabilize, worsen, or even subside.

 

Categories of Symptoms in Schizophrenia

symptoms of schizophrenia

Symptoms are classified into the following groups:

  1. Positive: distortion of normal body functions.
  2. Negative: decreased or loss of normal function and emotional response.
  3. Disorganized: erratic thinking and bizarre behavior.
  4. Cognitive: decreased ability to perceive, analyze and solve problems.

The patient may have symptoms from one or two categories.

 

Positive symptoms are divided into:

  • Delusional states
  • Ravings

 

Delusions are erroneous beliefs that the patient adheres to despite the presence of obvious conflicting facts. There are several types of delusions:

  1. Persecutory delusions: patients believe they have been tortured, persecuted, deceived, or watched over.
  2. False Relationships: patients believe that passages from books, newspapers, lyrics, or other environmental cues are directed at them.
  3. Delusions of detached thinking or forced thinking: patients feel that others can read their thoughts, that their thoughts are transmitted to others, or that their own thoughts and impulses are imposed from the outside

Delirium in schizophrenia does not come from the experience of ordinary life situations (for example, the belief that someone has removed the patient’s internal organs without leaving scars).

 

Ravings are sensory experiences that are not perceived by other people. They can be auditory, visual, olfactory, gustatory, or tactile, but auditory ravings are the most common. Patients may hear voices commenting on their behavior, talking to each other, criticizing, or making offensive comments about the patient. Delusions and ravings can be very annoying to patients.

 

Negative schizophrenia symptoms (defects) include:

  1. Blunted affect: the patient’s face is motionless, with poor eye contact and lack of expression.
  2. Poor speech: the patient speaks little and gives short answers to questions, giving the impression of an inner emptiness
  3. Anhedonia: lack of interest in any kind of activity and increased hectic, hectic activity.
  4. Asociality: lack of interest in relationships with others.

Negative symptoms often reduce the patient’s motivation and sense of the need to achieve a goal.

 

Disorganized symptoms that can be considered positive symptoms include:

  • Thought disorders;
  • Abnormal behavior;

 

With schizophrenia, the patient’s thinking is disorganized, differs in incoherent, aimless speech, he quickly moves from one topic to another. Speech can range from mild disorganization to complete inconsistency and unintelligibility. Bizarre behavior can manifest itself as childishness, agitation, lack of hygiene, and sloppy appearance. Catatonia is an extreme degree of behavioral disturbance in which the patient can assume a forced, rigid posture and resist attempts to move him or be involved in aimless and unstimulated motor activity.

 

Cognitive deficits include impairment in the following areas:

  • Attention functions;
  • Processing speeds;
  • Working or declarative memory;
  • Abstract thinking;
  • Problem-solving ability;
  • Understanding social interaction.

 

The patient’s thinking can be inflexible. There is a decrease in the ability to solve problems, understand the point of view of others, and learn from experience. The severity of cognitive impairment is a major factor leading to disability.

schizophrenia disorder

Types of Schizophrenia

Some scientists divide this psychotic disorder into deficient and non-deficient types of psychotic disorders, depending on the presence and degree of manifestation of negative symptoms, such as affective dullness, lack of motivation, and a decrease in the sense of achievement.

In patients with the deficiency type of schizophrenia, negative symptoms prevail with a blurred manifestation of other symptoms (such as depression, anxiety, in a stimulating environment, and side effects of drugs).

In patients with the non-deficient type of schizophrenia, delusional states, hallucinations, and thought disorders may be present, but negative symptoms are relatively rare.

 

Suicide

About 5 to 6% of patients with schizophrenia commit suicide and about 20% attempt suicide. Others are serious about committing suicide. Suicide is the leading cause of death in people with this psychotic disorder, which partly explains the decrease in their life expectancy by 10 years.

The risk may be especially high for young men with this psychotic disorder and substance use disorders. The risk is also increased in patients showing symptoms of depression or hopelessness, in the unemployed, and patients who have just experienced a psychotic episode or have recently been discharged from the hospital.

Patients with late-onset and normal premorbid courses are also at increased risk of suicide. Because these patients retain the ability to experience sadness and longing, they may be more likely to act in despair based on a realistic awareness of the effect of their disorder.

 

Violence

Schizophrenia is considered a relative risk factor for the development of violent behavior. Threatening behavior and outbursts of aggression are more common than dangerous behavior. Individuals with this psychotic disorder are generally less aggressive than non-schizophrenic individuals.

Highly abusive patients include those with substance abuse disorders, delusions, or imperative hallucinations and those who do not take their prescribed medications. People with severe depression, autism, or paranoia rarely attack or kill someone they perceive to be the only source of their illness (boss, celebrity, spouse).

 

Treatment

treatment of schizophrenia

Treatment methods include: 

  • antipsychotic drugs;
  • rehabilitation, including cognitive recovery, community-based training, and support services;
  • resilience-focused psychotherapy.

 

The time between the onset of psychotic symptoms and the initiation of the first course of treatment correlates with the rate of response to treatment and its quality. If treatment is started early, the patient’s response is faster and more complete. Without a long course of antipsychotics, 70–80% of patients relapse within 12 months after the first episode. Long-term use of antipsychotics can reduce the relapse rate in the first year by 30%, or even lower with long-acting drugs. Medication is given for at least 1 to 2 years after the first episode. If patients have been ill for a longer period, it continues for many years.

 

Early detection and comprehensive treatment have transformed the care of patients with psychotic disorders like schizophrenia. Coordinated specialized care, which includes resilience education, personal and family therapy to address cognitive dysfunction, and employment assistance, is an important contribution to psychosocial recovery.

 

Antipsychotic drugs are classified into typical antipsychotics and second-generation antipsychotics, depending on their affinity and activity against certain neurotransmitter receptors. ANLs can improve the effectiveness of schizophrenia treatment and reduce the likelihood of involuntary movements and associated side effects. Nevertheless, against the background of the use of ANL, the risk of developing metabolic syndrome (excessive formation of adipose tissue, insulin resistance, dyslipidemia, and hypertension) is higher than against the background of typical antipsychotics. Some antipsychotics of both classes can lead to long QT syndrome and ultimately increase the risk of fatal arrhythmias; these drugs include thioridazine, haloperidol, olanzapine, risperidone, and ziprasidone.

 

FAQs:

  • Can people with schizophrenia suddenly attack and try to kill?

Some factors can lead to an outbreak of aggression. But this does not mean that the sick is just waiting for someone to attack. If you have to deal with this, then protect the patient (close the windows, turn off the gas, take away knives and matches, etc.), yourself, family members, and animals and call an ambulance. There is no need to argue with the patient, mock, or demand to calm down or remember martial arts techniques. Maintain self-control and speak in a calm voice. 

  • When can a person with schizophrenia be considered healthy?

There is still no cure for schizophrenia. And there are many such diseases that, with the help of drugs, can only be brought into remission. For example, with diabetes mellitus or hypertension – people have to take drugs all their lives, but no one considers them to be damaged people. And, of course, the scientific world is looking for, developing, and testing drugs that can act as efficiently as possible.

  • Are you born with schizophrenia, or do you develop it?

This psychotic disorder tends to run in families, but no single gene is thought to be responsible. It’s more likely that different combinations of genes make people more vulnerable to the condition. However, these genes do not necessarily mean you’ll develop this psychotic disorder.

  • What does it mean to take schizophrenia “under control”?

To control means with the help of drugs and additional methods (psychotherapy, for example) to make the symptoms of the disease as little as possible affect life. This is called remission. With a favorable course of the disease, a person will remain in society and live almost the same way as before the diagnosis.

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Lone Star Neurology
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Edward Medina
Edward Medina
15:34 30 Jun 22
Just such an amazing staff that makes you feel like part of their family. I’ve been going there for over 5 years now... and each visit I get the very best care and treatments that I have ever received in the 20+ years that I’ve been dealing with severe debilitating migraines. Since i started seeing them the number of my migraines has dropped from 15-20 a month to 2-3 every 3 month. I highly recommend them …they will change your life!read more
Daneisha Johnson
Daneisha Johnson
22:20 19 May 22
Dr. Askari was very kind and explained everything so I could understand. The other staff were nice as well. I would... have gave 5 stars but I was a little taken aback when I checked in and had to pay 600.00 upfront. I think that should have been discussed in a appointment confirmation call or email just so I could have been prepared.read more
Jean Cooper
Jean Cooper
16:54 29 Apr 22
I love the office staff they are friendly and very helpful. Dr. JODIE is very caring and understanding to your needs... and wants to help you. I will go back. would recommend Dr. Dr. Jodie to other Patients in a heart beat. The team works well together.read more
Linda M
Linda M
19:40 02 Apr 22
I was obviously stressed, needing to see a neurologist. The staff was so patient and Dr. Ansari was so kind. At one... point he told me to relax, we have time, when I was relaying my history of my condition. That helped ease my stress. I have seen 3 other neurologists and he was the only one who performed any assessment tests on my cognitive and physical skills. At one point I couldn't complete two assessments and got upset and cried. I was told, it's OK. That's why you're here. I was truly impressed, and super pleased with the whole experience!read more
Leslie Durham
Leslie Durham
15:05 01 Apr 22
I've been coming here for about 5 years. The staff are ALWAYS friendly and knowledgeable. The Doctors are the absolute... best!! Jodie Moore is always in such a great mood which is a plus when you are already stressed. Highly recommendedread more
Monica Del Bosque
Monica Del Bosque
14:13 25 Mar 22
Since my first post my thoughts have changed here. It's unfortunate. My doctor and PA were great, but the office staff... is horrible. They never call you back when they say they will, they misinform you, they cause you too much stress wondering what's going on, they don't keep you posted. They never answer the phone. At this point I've left four messages in the last week, and I have sent three messages. Twice from their portal and one direct email. No response. My appointment is on Monday morning at 8:30am, no confirmation on my insurance and what's going on. What the heck is going on, this is ridiculous!I've given up... the stress her office staff has put me through is just not worth it. You can do so much better, please clean house, either change out your office staff, or find a way for them to be more efficient please. You have to do something. This is not how you want to run your practice. It leaves a very bad impression on your business.read more
Ron Buckholz
Ron Buckholz
23:32 23 Mar 22
I was actually pleasantly surprised with this visit! It took me a long time to get the appointment scheduled because no... one answers your phones EVER! After a month, I finally got in, and your staff was warm, friendly, and I was totally impressed! I feel like you will take care of my needs!read more
Steve Nabavi
Steve Nabavi
16:28 16 Mar 22
It was a nice visit. Happy staff doing all they can do to comfort the patients in a very calming environment. You ask... me they are earned a big gold star on the fridge. My only complaint they didn't give me any cookies.read more
Katie Lewis
Katie Lewis
16:10 10 Feb 22
Had very positive appointments with Jodie and Dr. Sheth for my migraine care. Jodie was so fast with the injections and... has so much valuable info. I started to feel light headed during checkout and the staff was SO helpful—giving me a chair, water, and taking me into a private room until I felt better. Highly recommend this practice for migraine patients, they know what they’re doing!!read more
Joshua Martinez
Joshua Martinez
16:02 10 Dec 21
I was scheduled to be checked and just want to say that the staff was fantastic. They were kind and helpful. I was... asked many questions related to what was going on and not once did I feel as though I was being brushed off. The front desk staff was especially great in assisting me. I'm scheduled to go back for a mri and am glad that I'll be going there.read more
Isabel Ivy
Isabel Ivy
21:42 03 Nov 21
I had such a good experience with Lone Star Neurology, Brent my MRI Tech was so awesome and made sure I was very... comfortable during the appointment. He gave me ear plugs, a pillow, leg support and blanket, easiest MRI ever lol 🤣 My 72 hour EEG nurse Amanda was also so awesome. She made sure I was take care of over the 3 days and took her time with the electrodes to make sure it was comfortable for me! Paige was also a huge help in answering all my questions when it came to my test results, and letting me know her honest opinions about how I should go forth with my treatment.read more
Leslie Luce
Leslie Luce
17:37 20 Oct 21
The professionalism and want to help attitude of this office was present from the moment I contacted them. The follow... up and follow through as well as their willingness to find a way to schedule my dad was above and beyond. We visited two offices in the same day with the same experience. I am appreciative of this—we spend a lot of time with doctors and this was top notch start to finish.read more
robert Parker
robert Parker
16:38 16 Apr 21
I love going to this office. The staff is friendly and helpful. The doctor is great. I am getting the best... neurological tests and treatment I have ever had. The only reason I did not give them a 5 star rating is because it is impossible to reach a live person at the office to reschedule appointments. Every time I have tried to get through to the office it says all people are busy and I am sent to a voicemail. If they could get their phone answering fixed, I would give them a strong 5 stars.read more
MaryAnn Hornbaker
MaryAnn Hornbaker
00:26 25 Feb 21
Dr. Harney is an excellent Dr. I found him friendly , personable and thorough. I evidently am an unusual case. ... Therefore he spent a Hugh amount of time educating me. He even gave me literature to further explain my condition and how to follow up. This is something you rarely get from your doctors. So I am more than please with my doctor and his staff.read more
Roger Arguello
Roger Arguello
03:05 29 Jan 21
Always courteous, professional. The staff is very friendly and always work with you to find the best appointment time.... The care team has been great. Always taking the time to listen to your concerns and to find the best treatment.read more
Margaret Rowland
Margaret Rowland
01:12 27 Jan 21
I have been a patient at Lone Star Neurology for several years. Now both my adult daughters also are patients there. I... love Jodie. She is always so prompt whether it is a teleamed call are a visit in the office. She takes the time to explain everything to me and answers all my questions. I am so blessed to have Jodie as my doctor.read more
Susan Miller
Susan Miller
03:01 13 Jan 21
My husband had an accident 5 years ago and Lone Star Neurology has been such a blessing to us with my husbands care.... Jodie Moore is his provider and she is amazing! Jodie is very knowledgeable, caring, and thorough. She takes her time with you, making sure your needs are met and she is happy to answer any questions you may have. Lone Star Neurology’s patients are very lucky to have Jodie providing their care. Thank you Lone Star Neurology and especially Jodie for everything you have done for us. Jodie, you are the best!read more
Windalyn C
Windalyn C
01:32 09 Jan 21
Jodie is wonderful. She is very caring and knowledgeable. I have been to over a dozen neurologists, and none were able... to help me as much as they have here. Thanks!read more
Katie Kordel
Katie Kordel
00:40 09 Jan 21
Jodi Moore, nurse practitioner, is amazing. I have suffered from frequent, debilitating headaches for almost 20 years.... She has provided the best proactive and responsive care I have ever received. My quality of life has been greatly improved by her caring approach and tenacity in finding solutions.read more
Ellie Natsis
Ellie Natsis
15:41 07 Jan 21
I have had the best experience at this neurologist's office! For over a year I have been receiving iv treatments here... each month and my nurse, Bobbie is beyond wonderful!! She's so attentive, knowledgeable, caring, and detail oriented. She makes an otherwise uncomfortable experience much more pleasant and definitely puts me at ease! She also helps me with my insurance,ordering this specialty medication and dealing with the ordering process which is no easy feat.Needless to say, she goes above a beyond in every way and I'm so grateful to this office and to Bobbie for all they do for me!read more
Matt Morris
Matt Morris
15:39 07 Jan 21
Let me start by saying that I have been coming here for years. Due to my autoimmune disease, I am in this office... once every three weeks for multiple hours at a time. The office is very clean and the staff very friendly. My only complaint would be there communication via phone. They aren't the best at responding if you leave a voicemail and expect a call back. I understand that this is prob just due to the sheer number of alls they receive daily. What I can say I like the best about the office are the people. Bobby who handles my infusions is great. I never have any issues with her setting up my infusions. She is very quick to reply to messages sent via text and if she were to leave then my whole opinion of the office may change. I also enjoy people like Matt, Lauren, and Jodi. I appreciate all that they do for me and without this team I'm not sure I would be as happy as I am to visit the office as frequently as I have to. Please ensure that these folks are recognized as they are what makes my visit to this office so tolerable :).read more
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