Though the dysfunction of central dopamine system has been proposed, the pathogenesis of schizophrenia is still uncertain partly due to limited accessibility to dopamine receptor. Many studies in humans documented that appropriate stimulation of dopamine D1 receptors in the dorsolateral prefrontal cortex is critical for working memory processing, attention span, perseverance, planning, judgment, impulse control, organization, self-monitoring and supervision. It also is responsible for problem solving, critical thinking, forward thinking, learning from experiences and mistakes, ability to feel and express emotions, influences the limbic system, empathy and internal supervision . The dopamine hypothesis that occurs in patients with schizophrenia is a core feature of this illness.
Imagine for the moment that your daughter just left for college and you hear voices inside your head shouting, “You’ll never see her again, you have been a bad mother, she’ll die.” Or, what if you saw dinosaurs on the street and live animals in your refrigerator? These are actually experiences that have plagued Mrs. X for almost three decades. Mrs. X suffers the disorder known as schizophrenia. Schizophrenia is an internal disease caused by fundamental organizational differences in the brain, and is triggered by drug use, stress, and one’s environment, thus making it difficult to diagnose.
Dear Sirs: Pertaining to our continuing failure to prosecute violations of minor’s rights to sovereign equality which are occurring in gestations being compromised by the ingestation of controlled substances,… the skewing of androgyny which continues in female juveniles even after separation from their mother’s has occurred, and as a means of promulflagitating my paying Governor Hickel of Alaska for my employees to have personal services endorsements and controlled substance endorsements,… the Iraqi oil being released by the United Nations being identified as Kurdistanian oil, and the July, 1991 issue of the Siberian Review spells President Eltsin’s name without a letter y. (Clarke-Stewart, B., & Wickens, R., p.514+515).
The disorganization and bizarre content of this letter suggests that its writer suffers from schizophrenia, a pattern of severely disturbed thinking, emotion, perception, and behavior that seriously impairs the ability to communicate and relate to others and disrupts most other aspects of daily functioning. Schizophrenia is one of the most severe and disabling of all mental disorders. Its core symptoms are seen virtually everywhere in the world, occurring in about 1% of the population (Gottesman, 1991).
There are three basic types of schizophrenia. One, Disorganized Schizophrenia (previously called “hebephrenic schizophrenia”) is the lack of emotion and disorganization in a person. Secondly, Catatonic Schizophrenia which gives a person waxy flexibility, reduced movement, rigid posture, sometimes too much movement. Lastly, Paranoid Schizophrenia, which the person receives strong delusions or hallucinations.
Mental illness-madness, if you will-has been with us throughout recorded history. The Old Testament warns those inclined to break the Ten Commandments that “the Lord will smite you with madness and blindness and confusion of mind.” The ancient Roman poet Horace (65- 8 B.C.) wrote of a man who each day took a seat in an empty theater and enjoyed a performance no one else could see or hear, roundly applauding actors who existed only in his mind. Much later, the English playwright William Shakespeare(1564-1616) drew heavily on the theme of the deranged mind for dramatic impact in such classics as Macbeth, Hamlet, and King Lear.
Dr. Emil Kraepelin (1855-1926), a German psychiatrist, first described schizophrenia in a study. The term he coined for the condition he observed was dementia praecox, literally precocious (i.e. unusually early) mental deterioration. Kraepelin’s work was to serve as a basis for all future research into schizophrenia. His observations of patients suffering from dementia praecox formally identified for the first time many of the symptoms of schizophrenia and many of his diagnostic principles are still used by psychiatrists today. His work stands as a landmark achievement in the field of psychiatric research.(Faraone, S. & Tsuang, M., p.7) Kraepelin (www.pbs.org/wnet/brain/history/images/1896.jpg)
Kraepelin’s work was to provide much of the base material and academic inspiration for the second great father of schizophrenia research, Dr. Eugene Bleuler (1857-1939). He created the term schizophrenia which literally means, “split mind” in 1911, when he was referring to the fragmenting of thought processes and emotions found in schizophrenic disorders. As for the content of his research, it consisted in essence of extending Kraepelin’s concept of the illness so that it included the main symptoms of dementia praecox together with those of paraphrenia a separate condition the latter had named to describe patients with delusions and hallucinations, but without other symptoms of dementia praecox.
Bleuler listed the primary manifestations of schizophrenia as thought disorder, emotional blunting (that is to say an inability to experience normal emotions), and an impaired relationship with the external world. He considered thought disorder and emotional blunting, to be “fundamental” or “primary” symptoms of schizophrenia and delusions or hallucinations to be “accessory” or “secondary” to them. He examined his patients over a long period of time and concluded that, there were significant residual symptoms. We now know that this need not always be the case (Faraone, S. & Tsuang, M., p.7+8). A lot of young people blame life at home with their parents as the cause of many problems or maladjustments of many kinds, including serious ones like schizophrenia. In some cases such an accusation may be reasonable in the future.
Can one’s environment, or experiences, or family really cause schizophrenia? Does stress cause schizophrenia? Or does having the wrong genetic factors or chemistry in your cells allow stress to make a person a better target for schizophrenia? For now, the only possible answer is “perhaps.” The effects of environment and family circumstances on the incidence of schizophrenia are being studied all the time. The answers to these questions may one day win the Nobel Prize in medicine for someone.
It is clear that studies have proven that schizophrenia is a brain disease. The functions of our minds and bodies depend upon the continuous action of electrical and chemical processes. The brain is part of the body’s nervous system. It has billions of nerve fibers. When a stimulus-a noise or a light or smell, for example-acts upon a nerve ending at one of the sensory organs such as eyes, ears, or nose, the information is then carried as an electrical impulse, or signal, to the brain.