Research Paper on Pathophysiology of Schizophrenia

Introduction

Schizophrenia is a disorder in the brain that affects the process of thinking, perception, and feeling of a person. Schizophrenia is a complex disorder; it involves dysregulation of the multiple pathways in its pathophysiology. The neurotransmitters systems that are affected by schizophrenia include Dopaminergic, GABAergic, and glutamatergic and interactions between these receptors contributing to the pathophysiology of schizophrenia. The main symptom of this disorder is psychosis, which entails having experiences of auditory hallucinations in the form of voices and delusions, which are fixed false beliefs.

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People who have this disorder tend to have lost touch with the real world. Schizophrenia is not a common mental disorder; its symptoms can be incapacitating. The factors that can result in the development of this disorder include genes and environment. Scientific research has shown that some patients who have developed schizophrenia are due to family lineage but not all the cases. About 0.3 % and 0.7 % of people are affected by schizophrenia in their lifetimes(Lewis & Levitt, 2002) . Secondly, different structure and brain chemistry according to studies conducted by scientist an imbalance in the complex, integrated chemical reactions of the brain consisting of neurotransmitters glutamate and dopamine have a crucial role in schizophrenia. This paper is a discussion of the pathophysiology on schizophrenia.

Normal Anatomy of the Significant Body System Affected

The central part of the body that is affected by schizophrenia is the brain. Majority of the effects of schizophrenia are emotional or mental. Schizophrenia patients have brains which function look different as compared to healthy people (Tamminga & Medoff, 2002). This is due to the malfunctioning of the brain messenger system of neurotransmitters. Untreated schizophrenia has various effects on the body; this disorder is also connected to illegal drug usage and alcohol. These complications result in different physical health problems, which include liver failure or heart disease. Schizophrenia patients are, in most cases, develop health problems which are preventable such as high cholesterol and high blood pressure.

Normal Physiology of the Major Body System Affected

The physiology of schizophrenia entails environmental interactions and complex genetics. The study of the physiology of schizophrenia has enlarged beyond dysfunction of dopamine and entails glutamate, serotonin and nicotinic system, also physiological abnormalities such as inflammation and diabetes.

Mechanism of Pathophysiology

The underlying mechanism of schizophrenia, it is a mental disorder which is characterized by a disintegration of the process of thinking and emotional responsiveness which are involved. There are several theories which attempt to explain the connection between altered brain function and schizophrenia, such as glutamate hypothesis and the dopamine hypothesis. There is a poor understanding of the exact pathophysiology of schizophrenia. The theories that have been much supported are the glutamate hypothesis and the dopamine hypothesis. The recent approaches which have been identified have their concern around abnormalities in the immune system, oxidative stress, dysfunction of interneurons, and defects in myelination.

Dopamine hypothesis is one of the theories under the mechanisms of schizophrenia. Dopamine is a neurotransmitter which is in the brain, and it plays a role in the mesolimbic pathway and the symptoms of schizophrenia that are positive (Potkin et al., 2003). The involvement of dopamine in the mechanism of schizophrenia was introduced first because of the ability of phenothiazine to decrease psychotic symptoms. Also, amphetamines aggravate psychotic signs because of this dopamine agonist effect. Neurotransmitter serotonin may be involved in the machine; this is according to recent research as atypical antipsychotic medications.

Glutamate hypothesis plays a more significant role in the pathophysiology of schizophrenia. The glutamate hypothesis was established because of the lower number of glutamate receptor observed in the brain of schizophrenia patients. Research has supported the importance of these receptors after identifying that drugs with a mechanism which hindered the glutamate receptors tend to precipitate schizophrenia signs.

Structural abnormalities is another theory that is under the mechanism of schizophrenia. There is evidence that brain structure may influence the probability of a person to suffer from schizophrenia. Different imaging techniques such as diffusion tension imaging (DTI), computed tomography (CT), and magnetic resonance imaging (MRI) have been used to visualize brain structure, establishing a pattern of the victims. The volume of hippocampal was reduced, and brain size decreased according to meta-analysis. Also, ventricle enlargement was observed in people after the initial psychotic episode. Patients who have schizophrenia have a prefrontal cortex, anterior cingulate cortex, or temporal cortex which have an abnormal structure.

Position emission tomography (PET) scans have been used to observe the functional abnormalities of the brain. PET scans have made it easier to measure the metabolic rate for glucose and cerebral blood flow as indicative factors for synaptic activity in the brain. Studies conducted shows that people living with schizophrenia have a decrease in cerebral blood in the left parahippocampal region.

Prevention

Schizophrenia is a mental disorder which has a diverse impact on the caregivers, patients, and society at large. The treatment of this disorder is costly. The preventive measure for this disorder includes avoiding social isolation, maximizing individual mental health, learning how to lower stress and elimination of anxiety and depression. For pregnant women, the best way of preventing schizophrenia is through avoiding dry cleaning chemicals during pregnancy, avoiding all medications and not smoking cigarettes or use of tobacco products during pregnancy. Additionally, pharmacotherapy can be used in the prevention of schizophrenia, and this is secondary prevention which seeks to prevent conversion to the full-blown psychotic illness.

Treatment

When a patient has been diagnosed with schizophrenia treatment plan must be started immediately. This disorder requires long term treatment even when the symptoms lessen. A psychiatrist who has experience in the treatment of schizophrenia usually give guidelines for treating the patients (Fatani et al., 2017). Treatment of schizophrenia involves the use of medicines, psychosocial therapy to manage the situation and in a few instances, hospitalization. Antipsychotic medications are the most used drugs for treating schizophrenia. Second-generation antipsychotics, which include Aripiprazole, Asenapine, Olanzapine, and Ziprasidone, among others, are used to treat these patients. Additional, patients who are drug therapy-resistant are treated using Electoconclusive therapy (ECT), especially those who are depressed.

Clinical Relevance

There is clinical relevance of schizophrenia for quantifications of treatment effects in schizophrenia. Patients need to attend the clinic to check the way they are responding to the medications that they have been prescribed. Measurement is a crucial aspect of clinical relevance. It helps in the identification of the severity of symptoms and frequency; hence, proper medication is prepared for the patient. Clinical significance of schizophrenia help in identifying whether there is a relapse.

Conclusion

Schizophrenia is a vast prevalent psychiatric disorder. There are various emerging treatment options where newer drugs have been identified, and others modified through a combination of the existing ones. The main organ of the body that is usually affected is the brain. There is a various preventive measures for this disorder, such as changing lifestyles, especially for drunkards. Medicines and therapies are used for the treatment of schizophrenia.

References

Fatani, B. Z., Aldawod, R., Alhawaj, F. A., Alsadah, S., Slais, F. R., Alyaseen, E. N., ... & Banjar, J. (2017). Schizophrenia: Etiology, Pathophysiology, and Management-A Review. Egyptian Journal of Hospital Medicine, 69(6).

Lewis, D. A., & Levitt, P. (2002). Schizophrenia is a disorder of neurodevelopment. Annual review of neuroscience, 25(1), 409-432.Retrieved from https://www.annualreviews.org/doi/abs/10.1146/annurev.neuro.25.112701.142754

Potkin, S. G., Saha, A. R., Kujawa, M. J., Carson, W. H., Ali, M., Stock, E., ... & Marder, S. R. (2003). Aripiprazole, an antipsychotic with a novel mechanism of action, and risperidone vs. placebo in patients with schizophrenia and schizoaffective disorder. Archives of General Psychiatry, 60(7), 681-690.Retrieved from https://jamanetwork.com/journals/jamapsychiatry/article-abstract/207579

Tamminga, C. A., & Medoff, D. R. (2002). Studies in schizophrenia: pathophysiology and treatment. Dialogues in clinical neuroscience, 4(4), 432.Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181694/