Psyhconeuroimmunology
of Schizophrenia and its management
By
Aysha
Siddiqui- Oct 10th, 2014
PSYC
6747- Dr. Debra Wilson
Walden
University
Schizophrenia
Description of
Schizophrenia
The National Institute of Mental Health (NIH) defines
Schizophrenia as ‘a chronic and severe brain disorder’ that many people on
history have suffered from. People who suffer from the disorder hear voices in
their heads that others don’t and think that people are trying, planning to
hurt them. This can result in the patients being totally withdrawn or very
agitated. Schizophrenic patients can affect their whole families and some
societies also feel the impact of this kind of disorder (NIH), as these people
are unable to sustain jobs, homes on their own. Treatment may help reduce and
relieve the symptoms, but it’s not uncommon for schizophrenics to struggle with
their disorder for their entire life. Tandon, Nasrallah, Keshavan (2009) write that
schizophrenia and its symptoms have gone through a lot of evolution for
diagnosis, treatment sake due to new diagnostic tools and difference in its
definition.
Causes
of Schizophrenia: The NIH reports that the causes of schizophrenia could be
genetics, environment and brain chemistry with an argument about genes not being
solely responsible and psychosocial factors play a role as well. According to Gilmore (2010) to distinguish schizophrenia
causes is getting harder now, since more patients now have no first degree
relative with the disorder. This undermines the genetic factor that has been
valid for many years. Gilmore’s study also reports that causes of schizophrenia
are ‘not one thing’ and explains that this disorder is caused by complex
interaction of genetic factors plus environmental factors.
Psychoneuroimmunology
theories related to Schizophrenia
Some
researchers believe that schizophrenia is caused by an abnormal trajectory of
the synapse and circuit formation that leads irregular brain wiring (Gilomore,
2010). It is also argued that environmental factors cause abnormal trajectory
and cause the disorder in a person who is genetically high risk found. Tanaka et al.,(2000) aimed to measure the serum IL-18 levels of 66
schizophrenic patients. The article states that from past research the authors
had observed that in schizophrenic patients the ‘activation of the inflammatory
response system including the Th1 cytokine response’ maybe connected to the
physiology of schizophrenia. The results confirm this hypothesis and the study
concludes, ‘ immune activation is involved in the pathphysiology of
schizophrenia’. Though, it has been stated by many researchers that
environmental risk plays a big a part in causes of schizophrenia, many health
authorities like the NIH and American Psychological association (APA) have distinguished
it as a brain disorder. Keeping that in mind it is logical to assume that
schizophrenia is a result of an unusual activity in the physiology of an
individual. According to Sperner-Unterweger
(2005) schizophrenia is a ‘heterogeneous ‘disorder caused by the interaction
between the central nervous system (CNS), the immune system and hormones. They
further add that non compensatory and factors that counteract contribute to
causing schizophrenia.
Behavioral,
Cognitive Interventions
Pilling et al., (2002) study analyzed past
research on four kinds psychological of interventions for schizophrenic
patients: cognitive behavioral technique (CBT), social skills training, family
intervention and cognitive remediation. They conducted a meta- analysis of all the
past studies and concluded that CBT is the most effective technique for
symptoms that are resistance to medication, with family therapy being the
second best technique. The article ends with suggesting further research in
ways to utilize CBT for schizophrenic patients.
CBT is a structured psychological technique that has been used
for many years to treat psychological like depression, stress and recently has
also been adopted to treat more serious mental illnesses like schizophrenia (Sensky et al., 2000). The two CBT techniques that I have chosen to
write about are skills oriented therapies and learning skills to handle the
‘voices’.
Skills oriented therapies: The
therapist can train schizophrenic patients to deal with life’s challenges by
equipping them with specific skills, training. This can include problem solving
skills, daily functional jobs and this could help reduce the daily stress,
which in turn prevents outbursts or hospitalizations. Getting skills training
can be an effective intervention in form of a chain reaction.
Skills to handle the ‘voices’: As
mentioned above one symptom that distinguished schizophrenia from other mental
disorders is that the patients ‘hear voices’ that other people can’t (NIH).
These voices could be of friends, enemies or of any nature. The symptoms also
include hallucinations and developing CBT that train schizophrenic patients to
‘handle’ or ignore these voices, hallucinations could be very effective way to
manage the disorder. Farhall,
Greenwood, Jackson (2007) suggests that CBT aimed at handling voices can actually increase
self-efficacy in patients which can be a powerful tool in management of
schizophrenia.
References
Farhall,
J., Greenwood, K. M., & Jackson, H. J. (2007). Coping with hallucinated voices
in schizophrenia: A review of self-initiated strategies and therapeutic
interventions. Clinical
Psychology Review, 27(4),
476-493.
Gilmore,
J. H. (2010). Understanding what causes schizophrenia: a developmental
perspective. American Journal
of Psychiatry, 167(1),
8-10.
Sensky,
T., Turkington, D., Kingdon, D., Scott, J. L., Scott, J., Siddle, R. &
Barnes, T. R. (2000). A randomized controlled trial of cognitive-behavioral
therapy for persistent symptoms in schizophrenia resistant to medication.Archives
of General psychiatry, 57(2),
165-172.
Sperner-Unterweger,
B. (2005). Biological hypotheses of schizophrenia: possible influences of
immunology and endocrinology. Fortschritte
der Neurologie-Psychiatrie, 73,
S38-43.
Tandon,
R., Nasrallah, H. A., & Keshavan, M. S. (2009). Schizophrenia,“just the
facts” 4. Clinical features and conceptualization. Schizophrenia research,110(1),
1-23.
Tanaka,
K. F., Shintani, F., Fujii, Y., Yagi, G., & Asai, M. (2000). Serum
interleukin-18 levels are elevated in schizophrenia. Psychiatry research, 96(1), 75-80.
What is Schizophrenia? National
Institute of Health (NIH).
Retrieved from Doi:
http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml
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