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montana fisher-shotton

on 5 January 2014

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Transcript of Schizophrenia

Montana Fisher-Shotton
Mrs. Burlakoff

What is Schizophrenia?

A mental disorder which breaks down thought processes and impairs emotional responses.
It affects the way someone acts, thinks and their perception of reality.
Causes of Disorder:
People with a first degree relative (i.e. parent or sibling) with schizophrenia have a 10% chance of developing the disorder, whereas an individual without a relative with the disorder have a 1% chance
Environmental Factors:

Genetic Mutations:
This graph shows the risk of developing schizophrenia based on the relationship to a person with schizophrenia
The highest risk is between identical twins where they share the same genes.
Genes and Environment
Exposure to viruses or malnutrition before birth
Stress (i.e. family stress, social stress)
Substance misuse
Geographical variation (no significant difference in incidence but more successful treatment in developing countries)
Prenatal influenza
Traumatizing events
This graph shows the environmental factors that increase the risk of developing schizophrenia.

The odds ratio shows the increased risk relative to the average person, which is represented by 1.
Symptoms and Diagnosis
Schizophrenia is often caused by various factors, it could be a combination of environmental and genetic factors that cause an individual to develop the disorder.
Positive Symptoms:
Delusions- beliefs that are not based in reality
Hallucinations- seeing or hearing things that don't exist
Disorganized behavior- can range from agitation to childlike silliness
Thought disorder- difficulty speaking and organizing thoughts
Negative Symptoms
Loss of interest in everyday life
Lack of emotion
Neglect of personal hygiene
Social withdrawal
Lack of motivation
Reduced ability to plan and carry out activities
Cognitive Symptoms
Problems making sense of information
Difficulty paying attention
Memory problems
These can be the worst symptoms because they interfere with the performance of daily tasks the most.
Location of allele:
Frequency in Populations
Frequency in Canada
Schizophrenia affects males and females equally
Roughly 300,000 people in Canada have been diagnosed with schizophrenia
Affects about 1% of the population
Typically occurs between the late teens and mid-thirties
Genetic Screening/ Testing
Treatments and Management
Evolutionary Advantages/ History
Evolutionary Mechanisms
Overall, the rates of new cases of schizophrenia are similar in developing and developed nations.

There is a difference seen in urban and rural rates, with urban rates being twice the rural rates.

In developing countries the treatment is better and therefore the remission rate is better.

How is it diagnosed?
Schizophrenia is very hard to diagnose; some of the first symptoms can be a change in friends, drop in grades or irritability.
Often individuals are diagnosed by a psychiatrist evaluating clinical symptoms (positive, negative and cognitive symptoms) for 6 months
There is no reliable test that will diagnose schizophrenia
Often schizophrenic patients do not believe they have a psychotic illness

Some types of schizophrenia are caused by genetic mutations that occur involving different chromosomes and genes. Currently, the focus of studies are being done on the N-methyl-D-aspartate receptors (NMDAR) which is located in the limbic region of the brain. It controls memory and emotion, so it is believed that the genetic mutations causing schizophrenia affect this part of the brain.
The chromosomes containing genes that make a person more susceptible to schizophrenia are:
1,2,3,5,6,8,10,11,13,14,20 and 22
In the World
The location will vary depending on the type of schizophrenia.
The gene DISC1 has strong genetic ties to schizophrenia, it is disrupted in a t(1;11)(q42.1;q14.3) translocation shown in the picture below
Often to treat schizophrenia a combination of medications and psychotherapy.
Anti-psychotic drugs are used, and usually antidepressants are used to treat depressive symptoms
Some drugs used include: Clozaril, Seroquel, Risperdal, Zyprexa and more
Psychotherapy helps to teach them social skills, ensures that they stay on their medication and provides support to the individual
There is also family therapy and vocational and employment support which helps them find and keep a job
Sometimes patients must be hospitalized for substance abuse, extreme symptoms, if the drugs have any unexpected or negative side affects or psychological stress
Patients who are unable to work in some countries are eligible for government programs which assist them
It is a myth that schizophrenics are violent and dangerous
It is also a myth that schizophrenics need to stay hospitalized
There are many different types of schizophrenia, each with different causes. For example, post-traumatic schizophrenia is caused by a traumatic event rather than strictly genetics or gene mutations
Evolutionary Advantages:
Religious related delusions which enhance religious rituals
Schizophrenics have a higher resistance to shock, infection, allergies and high doses of histamine, insulin, thyroxin and other substances
Protective function because individuals are always alert
Milder forms of schizophrenia exhibit more divergent thinking
Group splitting: schizophrenic symptoms were usually prominent enough to break up tribes which is essential to maintain numbers
"Schizo" means split and "phrene" means mind, from Greek roots to describe the fragmented thinking
Disease was first identified as a mental illness by Emile Kraepelin in 1887
In 1911 Eugen Bleuler coined the term "schizophrenia"
Together, Bleuler and Kraepelin distinguished 3 different types of schizophrenia (Disorganized, catatonic and paranoid)
Now there have been more catagories added
Even Earlier
During the 14th century asylums and institutions were created for the mentally ill
Patients were exposed to brutal treatments and conditions at these asylums (straitjackets, chained up etc.)
During the middle ages, it was thought that schizophrenia along with other mental
Bedlam- one of the first asylums
illnesses was caused from being possessed by demons
Inhumane treatments were performed on patients, such as drilling holes in their skulls
Tests have been designed to predict chances of developing schizophrenia based on genes for the hereditary types of schizophrenia.

For example: in 2012 researchers at the Indiana University of Medicine developed a test based on various previous studies which looked at the genes most associated with the disease. two thirds of the time this test was able to determine how if the patient had a high or low risk of developing schizophrenia.

Scientists are still trying to develop a reliable and consistent method for determining chances of getting schizophrenia and testing a person to see if they have schizophrenia.
How does it remain in the population?
Individuals with schizophrenia reproduce less which is a negative selection factor, and should reduce the frequency of the genes in the population associated with the disease
Relatives reproductive rates are higher, and since they may possess the genes associated with schizophrenia this compensates for the loss of genes by affected patients
Therefore this explains why schizophrenia has had a stable prevalence of 1%
MRI's are used to evaluate schizophrenic's brains
Scans from patients first episode show that they have less brain tissue (compared to an unaffected healthy individual)
The use of anti-psychotic drugs lead to higher loss of brain tissue
This diagram shows the brains of identical twins, the left is the unaffected twin whereas the right has schizophrenia. The ventricles in the schizophrenic twin are larger.
Natural Selection:
A Brief History of Schizophrenia | Psychology Today. (n.d.). Retrieved from http://www.psychologytoday.com/blog/hide-and-seek/201209/brief-history-schizophrenia
Allelic association of the neuronal nitric ox... [Mol Psychiatry. 2002] - PubMed - NCBI. (n.d.). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12140778
Article. (n.d.). Retrieved from http://protein.bio.msu.ru/biokhimiya/contents/v72/full/72059999.html
Distinct brain disorders biologically linked - Wellcome Trust Sanger Institute. (n.d.). Retrieved from http://www.sanger.ac.uk/about/press/2013/130804.html
Elsevier. (n.d.). Retrieved from http://www.sciencedirect.com/science/article/pii/S0920996400000621
Environmental influences in schizophrenia: the known and the unknown. (n.d.). Retrieved from http://apt.rcpsych.org/content/10/5/323.full
Evolutionary Advantage to Schizophrenia | On Psychology and Neuroscience. (n.d.). Retrieved from http://psychneuro.wordpress.com/2010/03/30/evolutionary-advantage-to-schizophrenia/
Gene Mutation in Schizophrenia Linked to Mental Disorders | LiveScience. (n.d.). Retrieved from http://www.livescience.com/10346-gene-mutation-schizophrenia-linked-mental-disorders.html
Mutated Gene is among the causes of Schizophrenia | MentallyFine. (n.d.). Retrieved from http://mentallyfine.com/mutated-gene-is-among-the-causes-of-schizoprenia/
Gene Mutation Tied to Schizophrenia Identified | Psych Central News. (n.d.). Retrieved from http://psychcentral.com/news/2013/01/27/gene-mutation-tied-to-schizophrenia-identified/50818.html
Genetic Test May Predict Risk Of Schizophrenia - Medical News Today. (n.d.). Retrieved from http://www.medicalnewstoday.com/articles/245591.php
NIMH • Schizophrenia. (n.d.). Retrieved from http://www.nimh.nih.gov/health/publications/schizophrenia/index.shtml
Polimeni , J. (n.d.). Evolutionary Perspectives on Schizophrenia. Retrieved from http://ww1.cpa-apc.org:8080/publications/archives/cjp/2003/february/polimeni.pdf
Schizophrenia: a common disease caused by multiple rare alleles. (n.d.). Retrieved from http://bjp.rcpsych.org/content/190/3/194.full
Schizophrenia Cause and Prevention. (n.d.). Retrieved from http://www.schizophrenia.com/hypo.php
Schizophrenia.com - Schizophrenia Genetic Counseling. (n.d.). Retrieved from http://www.schizophrenia.com/szgencounsel.htm
Schizophrenia: genes and environment. [Biol Psychiatry. 2000] - PubMed - NCBI. (n.d.). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10682218
Schizophrenia: Signs, Symptoms, Types, Causes, and Effects. (n.d.). Retrieved from http://www.helpguide.org/mental/schizophrenia_symptom.htm
Schizophrenia: The Curse That's Almost a Blessing | DiscoverMagazine.com. (n.d.). Retrieved from http://discovermagazine.com/2007/dec/schizophrenia-the-curse-thats-almost-a-blessing#.Ur3cKvRDvuI
Social construction of schizophrenia - Wikipedia, the free encyclopedia. (n.d.). Retrieved December 28, 2013, from http://en.wikipedia.org/wiki/Social_construction_of_schizophrenia#Science_of_schizophrenia_and_comorbid_conditions
Team finds gene mutation that increases risk of schizophrenia, learning impairment / UCLA Newsroom. (n.d.). Retrieved from http://newsroom.ucla.edu/portal/ucla/gene-mutation-found-that-increases-247712.aspx

This time line shows the decade that different drugs were created to treat schizophrenia
During a study, researches evaluated 76 genes associated with schizophrenia and found 28 of them to have been positively selected during evolution
Doctors have reported that current schizophrenia cases are milder
This shows that the positive symptoms have remained in the population whereas the negative ones have not been passed on
DNA Microarray
Technology used to evaluate genes and gene expression patterns
Arranges hundreds of thousands of tiny gene sequences on a microscope slide
Shows which genes are active and which are not
Allows scientists to understand how cells normally function and how they function when certain genes are present or are not present
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