What are the known characteristics of schizophrenia and relate those to this patient?
Schizophrenia is a frightful debilitating psychiatric disorder delineated by chronic or recurrent psychosis. Schizophrenia is a clinical diagnosis based on the DSM-5 criteria. The patient in the case scenario showcases distinct features of schizophrenia. For instance, the age of onset. According to Orrico-Sánchez et al. (2020), the peak age of onset of schizophrenia is usually late teens to mid-thirties which corresponds to her age.
Similarly, schizophrenia manifests with hallucinations, disorganized thought, delusions, and disorganized behavior (Hany et al., 2022). In her case, she has both auditory and visual hallucinations, paranoia, thought blocking, episodes of unexpected rage, and crying. She is untidy and unkempt, a common phenomenon in schizophrenics.
Likewise, she utilized cannabis during her early teen and likely from an urban environment which is a known environmental risk factor for schizophrenia. Individuals with schizophrenia are at risk of concurrent alcohol use. Finally, individuals with schizophrenia have concomitant psychopathologies in their families (Hany et al., 2022). For instance, her first cousin had mental problems.
Genetics are sometimes attached to schizophrenia, explain this
Genetic factors have been implicated in the etiology of schizophrenia. For instance, polymorphisms of the neuregulin, dysbindin, and catecholamine O-methyl transferase genes, that normally participate in brain development and glutamate signaling, glutamate release, and regulation of dopamine function respectively (Hany et al., 2022).
Similarly, the risk of schizophrenia in an individual stands at 10 and 40% if one and both parents are schizophrenic respectively (Orrico-Sánchez et al., 2020). Finally, concordance rates in monozygotic and dizygotic twins are 30-40% and 10-15% respectively (Orrico-Sánchez et al., 2020).
What roles do neurotransmitters play in the development of schizophrenia?
Several studies propose the dysregulation and abnormalities in various neurotransmitters as part of the underlying pathophysiologic mechanisms for the development of schizophrenia. For instance, negative psychotic symptoms are attributed to diminished dopamine in the prefrontal cortical pathway whereas positive psychotic symptoms correlate to increased dopamine in the mesolimbic pathway (Hany et al., 2022).
Similarly, reduced dopamine in the nigrostriatal pathway manifests in schizophrenics as motor symptoms. Other neurotransmitter abnormalities include GABA hypoactivity, serotonergic hyperactivity, diminished glutamatergic neurotransmission, and alpha-adrenergic hyperactivity (Hany et al., 2022).
Explain what structural abnormalities are seen in people with schizophrenia.
Structural and functional alterations to the brain appear consistently in individuals with schizophrenia. For instance, atrophy of the prefrontal cortex, thalamus, and limbic system enlarged third and lateral ventricles, atrophy of the hippocampus and amygdala, and diminished grey matter in the temporal and parietal lobes (Hany et al., 2022).
Consequently, the array of cognitive changes such as inattention, poor executive functioning, impaired coordination, and memory impairment seen in schizophrenics has been attributed to the aforementioned structural changes.
How does genetics play in the development of bipolar 2 disorders?
Bipolar 2 disorder is characterized by at least an episode of mania and one major depressive disorder with no prior episodes of mania. Bipolar 2 disorder is considered a complex genetic disorder although the mode of transmission is yet to be established. Studies established a correlation between bipolar disorder and single nucleotide polymorphisms (O’Connell & Coombes, 2021).
Furthermore, individuals with first-degree relatives with bipolar disorder have up to a 10% risk of developing the condition as opposed to a 1 to 3% lifetime prevalence in the general population (O’Connell & Coombes, 2021). Finally, monozygotic twins have a concordance rate of approximately 40 to 70% (O’Connell & Coombes, 2021).
Hany, M., Rehman, B., Azhar, Y., & Chapman, J. (2022). Schizophrenia. In StatPearls [Internet]. StatPearls Publishing.
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