Schizophrenia and its Epidemiology

I have lately been on a rotation with psychiatry department voluntarily, learning the various behaviors of the man kind and was shocked to see the presentation of all those disorders which were not that horror-some in textbooks as they were in real. Schizophrenia, a psychiatric illness known for last 20 centuries is a quite atypical disease. Every patient had a different presentation.

Just to sum up, schizophrenia is a disease of increased dopamine levels and a serotonin theory says that its the raised 5HT. I would prefer to support the dopamine hypothesis that is stronger and way more evident by literature. While, a third theory stays on glutamate levels. Schizophrenia has 5 types, Paranoid, Residual, Catatonic, Disorganized and undifferentiated.

The prognosis isn’t on the type of the disease, rather greatly depends on which age group the person gets this illness. An older female patient who is married and gets a due importance by social system and have a healthy lifestyle with a good employment history and fewer relapses — makes the best of the prognosis. Keeping in mind that schizo patients suicide in a large number that mainly owe to the hallucinatory personas guiding them to do so.

Another rare combination during my literature review was, people born in cold season and any viral infection of mother during the development of the schizo patient can be the contributory factors. Nonetheless, genetic history is very important. If someone has the tendency of shooting dopaminergic tracts, then a joint of cannabis or any drug that can increase dopamine can be the only one shooter to cause the disease.

There are many MSA components that can help us diagnose schizophrenia but by my internal medicine buff interest, HVA(homovanillic acid) in urine shows high level of dopamines in the body, yet it is not diagnostic.

Medications are available but one of the leading options are antipsychotics. Antipsychotics have mainly older and more conventional drugs and newer with more safer use.

1% population suffers from this in various degrees. Almost all ethnic groups and all social classes have been seen suffering from this although a downward drift hypothesis suggests that it is more common in poor social class. On a PET scan, it is not rare to see that schizos have lower glucose metabolism is frontal cortex, the reason we see mood problems in these patients.

Another important thing to remember is, positive and negative symptoms. Can be associated to the treatment plan.

Lastly, while making the diagnosis one cannot forget the intensity of the disease that are summed up by the terms as, schizoid, schizotypal, schizoeffective and schizophreniform.

Also, the internationally accepted literature, ‘Diagnostic and Statistical Manual of Mental Disorders 5th Edition’,published in 2013 brought a newer concept of schizophrenia and deleting all the subtypes of this disease.

 

For now over and out.

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