Schizophrenia: Causes, Heredity, and Key Insights

Schizophrenia is a psychiatric condition that has severe effects on your physical and mental well-being. It disrupts how your brain works, interfering with things like your thoughts, memory, senses and behaviors. As a result, you may struggle in many parts of your day to day life. Untreated schizophrenia often disrupts your relationships (professional, social, romantic and otherwise). It can also cause you to have trouble organizing your thoughts, and you might behave in ways that put you at risk for injuries or other illnesses.

Schizophrenia is a complex mental disorder that affects approximately 24 million people worldwide, including a significant number in India. Understanding its causes and hereditary aspects is crucial for early detection and effective management.

What are the types of schizophrenia?

Psychiatrists once referred to different types of schizophrenia, like paranoid schizophrenia and catatonic schizophrenia. But the types weren’t very useful in diagnosing or treating schizophrenia. Instead, experts now view schizophrenia as a spectrum of conditions, including:

• Schizotypal personality disorder (which also falls under the category of personality disorders).

• Delusional disorder.

• Brief psychotic disorder.

• Schizophreniform disorder.

• Schizoaffective disorder.

• Other schizophrenia spectrum disorders (specified or unspecified). This diagnosis allows healthcare providers to diagnose unusual variations of schizophrenia.

Who does it affect?

Schizophrenia starts between ages 15 and 25 for men and people assigned male at birth (AMAB) and between 25 and 35 for women and people assigned female at birth (AFAB). It also tends to affect men and women in equal numbers. About 20% of new schizophrenia cases occur in people over age 45. These cases tend to happen more in men and people AMAB.

Schizophrenia in children is rare but possible. When schizophrenia does start in childhood, it’s usually more severe and harder to treat.

How common is schizophrenia?

Schizophrenia is a somewhat common condition. Worldwide, it affects 221 in every 100,000 people.

Symptoms and Causes

Schizophrenia can include a wide range of possible symptoms.

What are the five symptoms of schizophrenia?

Many people with schizophrenia can’t recognize that they have symptoms of schizophrenia. But those around you might. These are the five main symptoms of schizophrenia

• Delusions: These are false beliefs that you hold even when there’s plenty of evidence that those beliefs are wrong. For example, you might think that someone is controlling what you think, say or do.
• Hallucinations: You still think you can see, hear, smell, touch or taste things that don’t exist, like hearing voices.
• Disorganized or incoherent speaking: You may have trouble organizing your thoughts while speaking. This might look like trouble staying on topic, or your thoughts might be so jumbled that people can’t understand you.
• Disorganized or unusual movements: You might move differently than people around you expect. For example, you may turn around a lot for no clear reason, or you might not move much at all.
• Negative symptoms: These refer to a reduction or loss of your ability to do things as expected. For example, you might stop making facial expressions, or speak with a flat, emotionless voice. Negative symptoms also include a lack of motivation, especially when you don’t want to socialize or do things you ordinarily enjoy.

Because of these symptoms, you might:

• Feel suspicious, paranoid or scared.

• Not care about your hygiene and appearance.

• Experience depression, anxiety and suicidal thoughts.

• Use alcohol, nicotine, prescription medications or recreational drugs to try to ease your symptoms.

What causes schizophrenia?

There’s no one single cause of schizophrenia. Experts suspect schizophrenia happens for different reasons. The three main reasons include:

• Imbalances in chemical signals your brain uses for cell to cell communication.

• Brain development problems before birth.

• Loss of connections between different areas of your brain.

• What are the risk factors of schizophrenia?

While there aren’t any confirmed causes of schizophrenia, there are risk factors for developing the condition:

• Environment: Many factors in the world around you can increase your risk of developing schizophrenia. Being born during the winter increases your risk slightly. Certain illnesses that affect your brain, including infections and autoimmune diseases (where your immune system attacks part of your body), can also increase your risk. Extreme stress for long periods can also play a role in developing it.

• Development and birth circumstances: How you developed before you were born plays a role in schizophrenia. The risk of having schizophrenia goes up if your birthing parent had gestational diabetes, preeclampsia, malnutrition or a vitamin D deficiency while pregnant with you. The risk also increases if you were underweight at birth or if there were complications during your birth (like if you were born via an emergency cesarean section).

• Recreational drug use: Schizophrenia is linked with the use of certain recreational drugs, especially in larger amounts and earlier in life. The connection between heavy marijuana (cannabis) use as a teenager is one of the best-studied of these links. But experts aren’t sure if marijuana use is a direct cause of schizophrenia or if it’s just a contributing factor.

Is schizophrenia genetic?

Experts haven’t found one specific cause of schizophrenia, so they can’t say for sure if genetics cause schizophrenia. But if you have a family history of schizophrenia, especially a parent or sibling with it  you have a much higher risk of developing this condition.

Diagnosis and Tests

• How is schizophrenia diagnosed?

Your (or your loved one’s) healthcare provider can diagnose schizophrenia or its related disorders based on a combination of questions they ask, the symptoms you describe or by observing your actions. They’ll also ask questions to rule out other potential causes of your symptoms. They then compare what they find to the criteria required for a schizophrenia diagnosis.

According to the DSM-5, a schizophrenia diagnosis requires the following:

• At least two of the five main symptoms.

• You’ve had symptoms for at least one month.

• Your symptoms impact your ability to work or your relationships (friendly, romantic, professional or otherwise).

What tests will be done to diagnose this condition?

There aren’t any diagnostic tests for schizophrenia. But healthcare providers may run tests to rule out other conditions before diagnosing schizophrenia. The most likely types of tests include:

• Imaging tests. Healthcare providers will often use computerized tomography (CT), magnetic resonance imaging (MRI) and other imaging tests to rule out problems like stroke, brain injuries, tumors and other changes to your brain structure.

• Blood, urine and cerebrospinal fluid (spinal tap) tests. These tests look for chemical changes in bodily fluids that might explain changes in your behavior. They can rule out heavy metal toxicity or other causes of poisoning, infections and more.

• Brain activity testing. An electroencephalogram (EEG) detects and records the electrical activity in your brain. This test can help rule out conditions like epilepsy.

Case Study: Martin's Journey

Martin's story illustrates the impact of environmental factors on schizophrenia. After experiencing significant stress and trauma during his teenage years, Martin began exhibiting symptoms of schizophrenia in his early twenties. With comprehensive treatment, including medication and therapy, he has managed his symptoms effectively and maintains a fulfilling career.

Is Schizophrenia Hereditary?

The heritability of schizophrenia is estimated to be between 70% and 80%, indicating a strong genetic component.

However, it's important to note that while genetic predisposition increases risk, it does not guarantee the development of the disorder. Environmental factors and gene environment interactions play significant roles in the manifestation of schizophrenia.

Debunking Common Myths

There are several misconceptions about schizophrenia:

Myth: Schizophrenia is solely caused by poor parenting.

Fact: While family environment can influence mental health, schizophrenia is primarily linked to genetic and neurobiological factors.

Myth: People with schizophrenia have multiple personalities.

Fact: Schizophrenia involves disruptions in thought processes and perceptions, not multiple personalities.

Treatment and Management

Can schizophrenia be cured?

Schizophrenia isn’t curable, but it’s often treatable. In a small percentage of cases, people can recover from schizophrenia entirely. But this isn’t a cure because there’s no way of knowing who will relapse and who won’t. Because of that, experts consider those who recover from this condition “in remission.”

How is schizophrenia treated?

Treating schizophrenia usually involves a combination of medication, therapy and self-management techniques. These include:

• Talk therapy methods like cognitive behavioral therapy (CBT) can help you cope with and manage your condition. Long-term therapy can also help with secondary problems alongside schizophrenia, such as anxiety, depression or substance use issues.

• Electroconvulsive therapy (ECT). If other treatments don’t work, your provider may recommend ECT. This treatment involves using an electrical current applied to your scalp, which then stimulates certain parts of your brain. The stimulation causes a brief seizure, which can help improve brain function if you have severe depression, agitation and other problems. If you have ECT, you receive anesthesia. You’ll be asleep for this procedure and won’t feel any pain.

Seeking online psychologist consultation India can provide tailored support for managing schizophrenia effectively.

How soon after treatment will I feel better?

Your healthcare provider is the best person to tell you how long it’ll take for medication and therapy to work, as different medications take different amounts of time before their effects are noticeable. Your provider can also tell you about other treatment options that might help if the first treatments don’t work well.

How do I take care of myself?

If you have schizophrenia, you should do the following to help care for yourself and manage your condition:

• See your healthcare provider as recommended. Your healthcare provider will set up a schedule for you to see them. These visits are especially important to help with managing your condition.

• Don’t ignore or avoid symptoms. You’re more likely to respond to treatment and have a good outcome with early diagnosis and medical care.

• Avoid alcohol and recreational drug use. Alcohol and drug use can make schizophrenia symptoms worse and can lead to other issues. This includes using prescription medications in a way other than prescribed.

• Consider seeking support. Organizations like the National Alliance on Mental Illness can offer resources and information that can help.

Conclusion

Schizophrenia arises from a complex interplay of genetic, environmental, and neurobiological factors. While there is a hereditary component, it is not solely determinative. Understanding these multifaceted causes is essential for early detection, effective treatment, and reducing stigma associated with the disorder.

About the Author

Dr. Roshni is a Senior Psychologist at Click2Pro with over a decade of experience in mental health care. Specializing in complex mental health disorders such as schizophrenia, she is passionate about raising awareness and providing actionable insights to improve lives. Dr. Roshni combines her expertise in psychology with a compassionate approach, making mental health accessible and understandable for individuals and families. Her mission is to empower people with the knowledge and resources they need to navigate mental health challenges effectively.

FAQs

1. What are the main causes of schizophrenia?

Schizophrenia results from a combination of genetic predisposition, environmental exposures (such as prenatal complications and childhood trauma), and neurobiological factors, including neurotransmitter imbalances.

2. Can schizophrenia be passed down from parents to children?

Yes, having a parent with schizophrenia increases the risk for children; however, it is not a certainty, as environmental factors also play a significant role.

3. Is schizophrenia 100% hereditary?

No, while genetics contribute significantly, schizophrenia is not entirely hereditary. Environmental influences and gene-environment interactions are also crucial in its development.

4. What environmental factors contribute to schizophrenia?

Factors such as prenatal malnutrition, exposure to infections during pregnancy, childhood trauma, and substance abuse can increase the risk of developing schizophrenia.

5. Can schizophrenia skip generations?

Yes, genetic susceptibility can skip generations, meaning it may not manifest in every generation even if the genetic risk is present.