Final Project Annotated Outline - due in 20 hours

Schizophrenia

Vernessa Combs

PSY350: Physiological Psychology

December 10, 2019

Schizophrenia

The topic selected was schizophrenia. This is a severe and chronic mental disorder affecting the way humans think, feel and behave. Although this mental disorder is not very common, it has disabling symptoms.

Schizophrenia has continuously been viewed as a disorder that occurs in neurodevelopment. It is associated with a microdeletion syndrome of a chromosome. Neurons migrate to the pial surface from the brain's ventricular zone. "Migration of the neuron cell body is mediated via microtubule-based transport organized by the centrosome. First, the centrosome moves up the microtubule, followed by the nucleus and the cell body” (Pearlson, 2015). Neuronal migrations are reportedly caused by Reelin.

The etiology of schizophrenia is unknown, however, several risk factors have been associated with its development. These include environmental and genetic factors. Genetic factors are, however, insufficient to account for the development of the disease. They must be accompanied by other factors for the disease to develop. "Because the concordance rate for monozygotic twins only approaches 50%, genetic makeup alone is not sufficient for the development of schizophrenia, and non-genetic or sporadic forms of the disorder must exist” (Miyamoto et al, 2013).

Environmental factors that play an important role in the etiology of schizophrenia include obstetric complications such as hypoxia, preeclampsia, and premature birth. Other environmental factors include maternal viral infections and stress occurring in neurodevelopment. Stress during neurodevelopment may be caused by other factors such as microbial infections.

The pathology of schizophrenia includes the transcriptional dysregulation at the cerebral cortex and chromosomal conformations. “Anatomic, neurotransmitter and immune system abnormalities have been implicated in the pathophysiology of schizophrenia” (Miyamoto et al, 2013). Differences have been observed in the brains of people with schizophrenia compared to the brains of people without the disease in neuroimaging studies. The medial temporal areas of the brain have a decreased volume while the ventricles are larger. Structural abnormalities such as volume reductions and ventricular enlargements have been associated with the disease.

The dopaminergic system abnormalities are also associated with schizophrenia. The immune system is also disturbed in people with the disease. “Overactivation of the immune system (eg, from prenatal infection or postnatal stress) may result in overexpression of inflammatory cytokines and subsequent alteration of brain structure and function” (Nuckols et al, 2013). Anatomic abnormalities may also be observed in the hippocampus.

In the prefrontal cortex, there has been a reported increase in neuronal density. One of the areas of the prefrontal cortex, area 9, has been found to have a smaller size of neurons and increased density of the smaller neurons. "Patients with schizophrenia had a greater density of MAP2- immunoreactivity neurons in the superficial white matter compared to controls” (Kendler, 2018). Therefore, there might be structural changes in the brain that may need scanning to be noticed.

The treatment of schizophrenia involves antipsychotics, psychosocial treatments, and coordinated specialty care. Antipsychotic medications are taken regularly. The treatment of schizophrenia, however, requires the integration of psychological, psychosocial and medical inputs (Kendler, 2018). A multidisciplinary team is involved in treating a schizophrenic patient. The team may consist of a nurse, therapist and social worker. Treatment of schizophrenia is conducted on an outpatient basis since the patients do not need hospitalization.

The diagnostic and research technologies employed in clinical diagnosis include psychiatric evaluation and using DSM-IV. The doctor may check for the presence of hallucinations and delusions. Tests and screens may also be done such as a CT scan to determine whether the condition could have been caused by other diseases.

References

Kendler, K. S. (2018). Familial aggregation of schizophrenia and schizophrenia spectrum disorders: Evaluation of conflicting results. Archives of General Psychiatry, 45(4), 377-383.

Nuckols, C. C., & Nuckols, C. C. (2013). The Diagnostic and Statistical Manual of Mental Disorders, (DSM-5). Philadelphia: American Psychiatric Association.

Miyamoto, S., LaMantia, A. S., Duncan, G. E., Sullivan, P., Gilmore, J. H., & Lieberman, J. A. (2013). Recent advances in the neurobiology of schizophrenia. Molecular interventions, 3(1), 27.

Pearlson, G. D. (2015). Neurobiology of schizophrenia. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society, 48(4), 556-566.