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| ====== Schizophrenia ====== | ====== Schizophrenia ====== | ||
| - | {{ :nintchdbpict000287654150.jpg?300 |}} | + | {{ :nintchdbpict000287654150.jpg?300 |}} Retrieved from: http://fcscortland.org/schizophrenia |
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| ==== Etiology ==== | ==== Etiology ==== | ||
| - | Through the complex diagnosis of schizophrenia, the causes are not entirely known as to why one would directly be linked to the disorder. Genes and environment have been attributed to a probable cause as 10% of individuals who have a first-degree relative with the individual with schizophrenia. In the case of twins, the likelihood increases to a range from 10-65%. Through research it is shown that schizophrenia is not linked to a single gene in the biology thereby leading into the complexity of the disorder. This leads into the argument of genetic changes such as mutations as a cause for the illness. Other causes include pregnancy and birth complications such as low birth weight, premature labour and asphyxia during birth. | + | Through the complex diagnosis of schizophrenia, the causes are not entirely known as to why one would directly be linked to the disorder. Genes and environment have been attributed to a probable cause as 10% of individuals who have a first-degree relative with the individual with schizophrenia. In the case of twins, the likelihood increases to a range from 10-65%. Through research it is shown that schizophrenia is not linked to a single gene in the biology thereby leading into the complexity of the disorder. Many genes act synergistically resulting in changed neurotransmitter interactions (Harrison, 2014). Genetic risk for schizophrenia comes from changes in the DNA sequences, more specifically single nucleotide polymorphisms (SNPs) and copy number variants (CNVs). Several loci have been observed including CACNA1C which is a L- type calcium channel, DRD2, the dopamine D2 receptor, GRIA1, an AMPA receptor subunit and GRIN2A, a NMDA receptor subunit to name a few (Harrison, 2014). This leads into the argument of genetic changes such as mutations as a cause for the illness. Other causes include pregnancy and birth complications such as low birth weight, premature labour and asphyxia during birth. |
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| First a plan is set in order to target an optimal strategy for the patient to ensure their symptoms are regulated. The Care Programme Approach is initiated and used by professionals within the mental health services. This plan caters to the symptoms of the individual affected with schizophrenia. Second generation antipsychotics are typically administered as the initial therapy as opposed to first generation as the former presents fewer side extrapyramidal side effects however there are increased metabolic symptoms (Patel et al. 2014). Second generation antipsychotics include aripiprazole, olanzapine, paliperidone, quetiapine, risperidone and ziprasidone delivered through injection or tablet. Metabolic side effects are an increase in weight, fatigue, cholesterol and blood sugar (Healthwise Staff, 2011). | First a plan is set in order to target an optimal strategy for the patient to ensure their symptoms are regulated. The Care Programme Approach is initiated and used by professionals within the mental health services. This plan caters to the symptoms of the individual affected with schizophrenia. Second generation antipsychotics are typically administered as the initial therapy as opposed to first generation as the former presents fewer side extrapyramidal side effects however there are increased metabolic symptoms (Patel et al. 2014). Second generation antipsychotics include aripiprazole, olanzapine, paliperidone, quetiapine, risperidone and ziprasidone delivered through injection or tablet. Metabolic side effects are an increase in weight, fatigue, cholesterol and blood sugar (Healthwise Staff, 2011). | ||
| + | ======Future Direction====== | ||
| + | Currently, many experts believe there will not be a universal cure for schizophrenia, but rather progress will amount in stages. Clozapine, the most effective antipsychotic to this date, has significant side effects and thus causes patients to be uncompliant. Researchers now are investigating whether other antipsychotic medications can have potent efficacy, and reduced side effects, specifically atypical ones (Beaumont, 2000). It should be noted that atypical medications target receptors other than dopamine D2 receptors. Additionally, clozapine and typical current antipsychotics do not target negative symptoms of schizophrenia, and thus further research is being targeted at those symptoms (Miyamoto, Miyake, Jarskog, Fleischhacker & Lieberman, 2012). | ||
| + | While treatment through medication has been relatively successful at relieving the burden of positive symptoms, not much is known about this condition. Researchers emphasize the importance of first understanding the pathophysiology, then attempting to find the solution. It is believed that both genetics and environment play a role in developing this condition, as well as symptom severity, and as a result, more funding should be directed into this field (van Os, Rutten & Poulton, 2008). Although our progress in this disease appears to be superficial, physicians and researchers both believe that more effective treatments are in the near future. Through discoveries, not only will schizophrenia be better managed, but also other mental conditions - the once “black box” will be more understood. | ||
| - | ======Conclusion====== | + | {{:schizophrenia.pptx|}} |
| + | ======References====== | ||
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| + | Beaumont, G. (2000). Antipsychotics – The Future of Schizophrenia Treatment. Current Medical Research And Opinion, 16(1), 37-42. http://dx.doi.org/10.1185/0300799009117006 | ||
| - | ====== References ====== | ||
| Burton, N. (2012). A Brief History of Schizophrenia. Retrieved January 24, 2018, from https://www.psychologytoday.com/blog/hide-and-seek/201209/brief-history-schizophrenia | Burton, N. (2012). A Brief History of Schizophrenia. Retrieved January 24, 2018, from https://www.psychologytoday.com/blog/hide-and-seek/201209/brief-history-schizophrenia | ||
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| Gong, Q., Lui, S., & Sweeney, J. A. (2015). A selective review of cerebral abnormalities in patients with first-episode schizophrenia before and after treatment. American Journal of Psychiatry, 173(3), 232-243. | Gong, Q., Lui, S., & Sweeney, J. A. (2015). A selective review of cerebral abnormalities in patients with first-episode schizophrenia before and after treatment. American Journal of Psychiatry, 173(3), 232-243. | ||
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| + | Harrison, P. (2014). Recent genetic findings in schizophrenia and their therapeutic relevance. Journal Of Psychopharmacology, 29(2), 85-96. | ||
| Healthwise Staff (2011). Second-Generation Antipsychotics for Treating Schizophrenia. Michigan Medicine. | Healthwise Staff (2011). Second-Generation Antipsychotics for Treating Schizophrenia. Michigan Medicine. | ||
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| McIntosh, A. M., Owens, D. C., Moorhead, W. J., Whalley, H. C., Stanfield, A. C., Hall, J., ... & Lawrie, S. M. (2011). Longitudinal volume reductions in people at high genetic risk of schizophrenia as they develop psychosis. Biological psychiatry, 69(10), 953-958. | McIntosh, A. M., Owens, D. C., Moorhead, W. J., Whalley, H. C., Stanfield, A. C., Hall, J., ... & Lawrie, S. M. (2011). Longitudinal volume reductions in people at high genetic risk of schizophrenia as they develop psychosis. Biological psychiatry, 69(10), 953-958. | ||
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| + | Miyamoto, S., Miyake, N., Jarskog, L., Fleischhacker, W., & Lieberman, J. (2012). Pharmacological treatment of schizophrenia: a critical review of the pharmacology and clinical effects of current and future therapeutic agents. Molecular Psychiatry, 17(12), 1206-1227. http://dx.doi.org/10.1038/mp.2012.47 | ||
| NIMH » Schizophrenia. (2018). Nimh.nih.gov. Retrieved 23 January 2018, from https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml | NIMH » Schizophrenia. (2018). Nimh.nih.gov. Retrieved 23 January 2018, from https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml | ||
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| van Os, J., & Kapur, S. (2018). Schizophrenia. ScienceDirect. Retrieved 23 January 2018, from http://www.sciencedirect.com/science/article/pii/S0140673609609958?via%3Dihub | van Os, J., & Kapur, S. (2018). Schizophrenia. ScienceDirect. Retrieved 23 January 2018, from http://www.sciencedirect.com/science/article/pii/S0140673609609958?via%3Dihub | ||
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| + | van Os, J., Rutten, B., & Poulton, R. (2008). Gene-Environment Interactions in Schizophrenia: Review of Epidemiological Findings and Future Directions. Schizophrenia Bulletin, 34(6), 1066-1082. http://dx.doi.org/10.1093/schbul/sbn117 | ||
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