Schizophrenia

BASICS

A severe and persistent mental illness characterized by delusions, hallucinations, disorganization of thought and behavior, cognitive dysfunction, and impairment in reality testing

DESCRIPTION

Major psychiatric disorder with a variable course, typically involving prodromal, active, and residual psychotic symptoms with disturbances in thought, speech, affect, behavior, and perception

EPIDEMIOLOGY

Prevalence

Worldwide prevalence 7.2 per 1,000 people
Age of onset: typically <30 years, earlier in males (late teens to mid-20s) than females (early 20s to early 30s)

ETIOLOGY AND PATHOPHYSIOLOGY

Overstimulation of mesolimbic dopamine D₂ receptors, deficient prefrontal dopamine, and aberrant prefrontal glutamate (NMDA) activity results in perceptual disturbances, disordered thought process, and cognitive impairments.
Two genes, SRRM2 and AKAP11, have been discovered to be associated with an increased risk of schizophrenia while the gene PLCO demonstrates a shared increased risk of both schizophrenia and autism.

Genetics

If first-degree biologic relative has schizophrenia, risk is 8–10%.

RISK FACTORS

Antenatal risk factors include prenatal infection or malnutrition, obstetric complications leading to hypoxia, winter births, postnatal infections requiring hospitalization, urban birth, and advanced paternal age.
Risk factors across the lifespan include adolescent cannabis use, childhood trauma, urban residence, autoimmune disorders, severe and repeated stress, lower socioeconomic status, minority status, being a first- or second-generation immigrant, inadequate social support.

GENERAL PREVENTION

Educate all patients on the risks around marijuana use.

COMMONLY ASSOCIATED CONDITIONS

Nicotine dependence (>50%) and substance use disorders
Metabolic syndrome, diabetes mellitus

There's more to see -- the rest of this topic is available only to subscribers.

All content is protected by copyright and may not be used for AI model training or other unauthorized purposes.