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Schizophrenia – Why and How

The very first question asked by the parents of the recently diagnosed patient of schizophrenia is about the cause of it. The parents feel threatened that they might be blamed for causing psychological damage to the patient in his/her childhood which in turn lead to the disease in later teens or early adult life. They tend to introspect as to when and where did they go wrong. Some conflict-ridden families with marital discord tend to shift the blame on to the other spouse. The aggrieved parents tend to justify their methods of up-bringing the child, as they are sure that they did their best to ensure their child’s future. Most parents bring up their children according the dictates of their own personalities. Some parents are very strict, others democratic in their approach. Parents can be indulgent or inconsistent disciplinarians and some parents are openly hostile towards their children while others might practice benign neglect. Child rearing practices were given great importance in the causation of schizophrenia till ‘50s and ‘60s of the 20th century. But recent research in the field of psychosocial antecedents of schizophrenia concluded that these factors in themselves are not sufficient to cause schizophrenia. This is because schizophrenia can happen in the best of the circumstances and it need not happen in the worst of the circumstances. There is more to the causation of schizophrenia than screwed up upbringing of the patient.

From times immemorial schizophrenia has been considered due to possession by ghosts, djinns or other supernatural forces. Ever since schizophrenia has been recognized as an affliction of the brain, faulty parenting practices, social and psychological stress were speculated to be responsible for schizophrenia. Recent research in brain chemistry and discovery of anti-psychotic medicines have strongly refuted the psycho-social theories formulated in late 19th and early 20th centuries.
Genetics play an important role in the causation of schizophrenia. There is definite evidence that rate of occurrence of schizophrenia in families with one or more patients is definitely more than that of the general population and there is high rate of concordance in identical twins as they inherit similar set of genes from both the parents.

The medicines used for control of schizophrenia function by blocking the neuro-transmitter Dopamine at certain sites in the brain and also by influencing other neurotransmitters like serotonin, norepinephrine, GABA and some other neuropeptides. The evidence that biological factors are the root cause of schizophrenia has also been provided by investigations done with the help of modern methods of Radiological investigations like PET and SPECT scans and functional MRI. The abnormalities so detected are concentrated in Frontal, Temporal and Thalamic regions of the brain. Some impairment of some physiological measurements in patients of schizophrenia and their unaffected family members are also a strong pointer towards importance of genetic, biological factors for schizophrenia to happen. The combination of findings of alterations of the shape and size of specific brain structures and disturbances of availability of neuro-transmitters point to a neuro-developmental process in which the brain of the potential schizophrenic patient fails to grow normally.

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