Tiffany Conejo SchizophreniaFirst, in the article What is Schizophrenia by Herbert Y. Meltzer and Paul Liberman, Dr. Meltzer states that it can be difficult to describe schizophrenia. He compares it to rheumatoid arthritis and manic-depressive illness because schizophrenia cannot be defined like these illnesses. Dr. Meltzer believes that schizophrenia should be seen as a phenotype. A phenotype is a set of observable characteristics that forms from the interaction of its genotype with the environment. The main point of this paper is to discuss what this means, as it is the core idea behind a biopsychosocial perspective Not only does he believe it should be seen as a phenotype but also a disorder of the central nervous system.

This is the prevailing view of schizophrenia. Some of the symptoms of schizophrenia include delusions, hallucinations, thought disorder, affective and volitional disturbance, and personality aberrations. Unfortunately, people who are are schizophrenia suffer from these symptoms on the a daily basis throughout their lifetime <not necessarily every day ” most people have relatively symptom-free periods> The doctors suggest that abnormalities may be in neurotransmitters, autoimmune processes, or methylation of membrane phospholipids.

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?citation They claim that it is possible for a person with schizophrenia to have more than one of these abnormalities. Another theory that Metzler and Liberman have to what schizophrenia might be is to limit schizophrenia to a select group of central nervous system abnormalities. The doctors state, […] perhaps those without gross brain lesions and diffuse metabolic abnormalities, but including those with specific neurotransmitter, neuromodulator, or receptor abnormalities. Here he is suggesting a different way in seeing what schizophrenia may be. It has not been proven but it can definitely be a possibility. It is most definitely possible, and there is much research that you should have found on dopamine, NMDA receptors, glutamate etc. Schizophrenia is not a single disorder. One of the common psychological characteristics of schizophrenia is hallucinations. Hallucinations can be visual, but most commonly are auditory verbal hallucinations. They can be disturbing and typically take form of voices speaking either to or about the individual. According to Daniel C. Javitt and Robert A. Sweet, In Particular, AVHs You need to tell us what this acronym is. have been associated with volume loss and functional hyperactivity of the auditory cortex, suggesting that local pathology within these regions may contribute as well. Schizophrenia varies in each individual. A person is not schizophrenic 24 hours a day, but some may suffer from the symptoms at a higher degree. Second, This should not read like a series of book reports, but like an essay with a particular point of view being discussed”your “argument”. in the article Schizophrenia, by Michael J. Owen, Akira sawa, and Preben B Mortensen, these doctors state, Schizophrenia is a complex, heterogeneous behavioral and cognitive syndrome that seems to originate from disruption of brain development caused by genetic or environmental factors, or both. They believe the timing of these events may be uncertain. Not only the person with this disorder is affected but also their society is affected. Unfortunately, more than 50% of the people who are diagnosed with schizophrenia suffer from the psychiatric problems long term and 20% have chronic symptoms and disabilities. Being diagnosed would also mean that the life span of the individual gets cut 10-20 years less. Owen, sawa, and Mortensen distinguish the symptoms of schizophrenia from either being negative or positive symptoms. This is part of the DSM-5 diagnosis. A positive symptom would be delusions and hallucinations, where a sense of reality is lost. Negative symptoms would be impaired motivation, reduction in spontaneous speech, social withdrawal, and cognitive impairment. There is a lack of social and interpersonal behaviors. People with schizophrenia are not able to feel or express their emotions. This makes them withdraw from others or completely isolate themselves. It is also harder for individuals to relate to others. The positive symptoms in this disorder can be short term but some individuals suffer from the positive symptoms for the long term. Ultimately, anyone can be diagnosed with schizophrenia, the onset can be sudden in people who are perfectly healthy. The doctors also claim that the first episode of this disease can occur in late adolescence or early adulthood. To be diagnosed with schizophrenia a person does not need to pass a diagnostic test because those test are not available to doctors. Doctors have yet to find the roots of schizophrenia and once this happens, doctors then would be able to create a diagnostic test. For now doctors use the history and mental state to diagnose an individual with schizophrenia. The doctors also believe that the genes of an individual can have a cause to their schizophrenia. The amount of mutations that schizophrenia results from is unknown, but studies have found eleven rare copy number variants that can cause a high risk of schizophrenia. These doctors also mention that one gene can be responsible for more than one abnormality and one of them is schizophrenia. Other abnormalities include that can emerge are ADHD, bipolar disorder, major depressive disorder, and autism spectrum disorder. Not only do these doctors believe that the genes of an individual can cause schizophrenia, but they also believe that the environment of an individual can cause or have something to do with their schizophrenia. For about 100 years, a “stress-diathesis” hypothesis for schizophrenia has dominated. Some of the potential risk factors that these doctors mentioned were maternal stress, maternal infections, and pregnancy and birth complications. The risks can start as early as the first trimester in pregnancy. Also, fetal hypoxia is associated with decreased grey matter and increased cerebrospinal fluid in patients with schizophrenia. In a study conducted by Tyrone D. Cannon, Theo Erp, and Isabella M. Rosso, they stated Of the many types of OCs found to predict schizophrenia, fetal hypoxia has shown the strongest association […]. Surprisingly, those individuals that were born in late winter or early spring have reported higher rates of schizophrenia (Cannon, Erp, & Rosso 2002). Also, women who decide to have a child at an older age are more likely to pass on a mutation to their child, therefore increasing the risk of schizophrenia in that child. There are many environmental factors that can cause or be associated with schizophrenia and some of them include the use of cannabis, being born or raised in a city, and having young parents. Unfortunately, the possible association of all these environmental factors has not been proven and of course would be unethical to experiment. All researchers can really do is warn us to be more cautious with our environment.Also, in the article, Psychosocial Factors in the Neurobiology of schizophrenia: A Selective Review by Siow-Ann Chong, Caroline Lim, and Richard Keefe, these researchers attempt to examine the relationships between psychosocial factors and neurobiological factors. One of the factors to occur would be a life event. This is typically the death of a loved one or some sort of crisis. They conclude, Brown and Birly examined the rate of life events before the onset of the disorder among the patients diagnosed with schizophrenia, and found that 46% of the patients had at least one life event in the 3-week period just before the onset of the disorder ( Chong, Lim, Keefe, 2009). This is also suggesting that environmental factors can also have a triggering effect. Yes, but is it a cause of the underlying disorder?Next, some of the abnormalities of schizophrenia can be seen in brain structures. Impairments in working memory and other executive functions are common in schizophrenic patients. Functions like these rely on circuitry that includes the frontal lobe. In the article, Cortical Abnormalities In Schizophrenia Identified by Structural Magnetic Personanel ? Imaging, the researchers in this study found that within the frontal lobe, middle frontal gyrus, and the frontal medial cortex were significantly reduced in patients with schizophrenia (Goldstein et al., 1999). Also, they found that total cerebral volume was significantly different between people who are diagnose and those who are not (Goldstein et al., 1999). The frontal lobe abnormalities are associated with greater negative symptoms. During the first years of being diagnosed the brain starts to change, changes are more evident in the frontal lobes. In the article, Structural Brain Abnormalities and Their Relationship to Clinical Outcome, researchers concluded that reductions in frontal lobe gray and white matter volumes is correlated with poorer executive function (Andreasen et al., 2003).. By the time patients seek out medical help brain volume is significantly different compared to healthy individuals (Andreasen et al., 2003). Furthermore, in the last 5-10 years there has been great progress in finding new ways to treat schizophrenia, according to Owen, Sawa, and Mortensen, studies have shown some of the genetic makings of this disorder and are possibly a little closer in figuring out what this disorder really is about. In their article they also mention the importance of animal studies. Conducting these animal studies can help scientist and doctors become one step closer in answering the many questions of this disorder(Owen, Sawa, & Mortensen, 2016). For example, some of these questions would be which biological contexts, cells, and mechanisms are the key sites of convergence of genetic and environmental stressors, Owen , Sawa and Mortensen state. Efforts are being made to develop compounds that are effective not only for positive symptoms but also for negative and cognitive symptoms, […]. The doctors believe that the only way the advancement in treatment can occur is if cellular and animal modeling and clinical trials keep being conducted and if results are helpful. Finally, in the article, Iloperidone: a new option for the treatment of schizophrenia, by Andrew J Cutler, mentions how the lifetime prevalence is reaching 1.0%. Being diagnosed with schizophrenia comes with high risk of suicide, relapse, medical conditions, and recurrent hospitalization. This disorder can cause a great burden to the patient and their family. The costs of schizophrenia were at an unbelievable amount, Estimated annual direct and indirect costs of schizophrenia were US$62.7 billion in the USA alone in 2002, including $22.7 billion in excess direct medical costs and $32.4 billion in direct costs(Cutler). There are several treatments available for patients, but it is difficult to have one reliable treatment for all patients based on the fact that effectiveness of a treatment varies in each individual. Cutler talks about a new atypical antipsychotic agent, iloperidone, on its safety and effectiveness. This antipsychotic agent is available in the form of oral tablets and mainly directed at patients with acute schizophrenia. Results from animal experiments showed an increase in social interaction behavior and a relief in positive symptoms. The positive and negative syndrome scale-total (PANSS-T) is used to measure the severity of symptoms in patients with schizophrenia. Several short term and long term studies have been conducted to show the effectiveness of iloperidone. In the short term studies of 4-6 weeks iloperidone was well tolerated and some reactions included dizziness, dry iloperidone and showed that unexpected events of the long term use were unlikely. In conclusion, schizophrenia has always been a mysterious disorder for doctors. For the most part doctors can agree on very important key indicators of schizophrenia. Yes, it has clear diagnostic characteristics. Although, diagnostic tests are still not available, efforts in providing better treatments have increased. The importance of discovering the cause of schizophrenia has been the main goal for doctors that treat patients with this disorder. Hopefully the answers will emerge soon, bringing doctors one step closer on how schizophrenia can prevented or avoided. Reference PageAndreasen NC, Ho B, Nopoulose T, Arnt S, Magnotta V, Flaum M. Progressive Structural brain Abnormalities and Their Relationship to Clinical Outcome: A Longitudinal Magnetic Resonance Imaging Study Early in Schizophrenia. Arch Gen Psychiatry. 2003 Batten D, Schummer P, Selden Holly.(2017). Human Diseases and Conditions. Vol. 4. 3rd ed.p1748-1753. Farmington Hills, MI: Charles Scribner’s Sons.Cannon TD, Van Erp TGM, Rosso IM., et al. Fetal Hypoxia and Structural Brain Abnormalities in Schizophrenic patients, Their Siblings, and controls. Arch Gen Psychiatry.2002;59(1):35-41Chong S, Lim C, Keefe R, Psychosocial Factors in the Neurobiology of Schizophrenia: A Selective Review. Annals Academy of Medicine. 2009. Cutler AJ. Iloperidone: a new option for the treatment of schizophrenia. Expert Rev Neurother 2009;9(12):1722-41.Taylor and Francis Online. Goldstein JM, Goodman JM, Seidman LJ, et al. Cortical Abnormalities In Schizophrenia Identified by Structural Magnetic Resonance Imaging. Arch Gen Psychiatry. 1999;56(6):537-547.Javitt DC & Sweet RA. Auditory Dysfunction in Schizophrenia: integrating clinical and basic features. Neuroscience. 2015:16(9)Metzler HY, Liberman RP. What is schizophrenia?. Schizor Bull.1982;8(3) PubMed.Owen MJ, Sawa A, Mortensen PB. Schizophrenia, Lancet. 2016; 388(10039):86-97

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