Data from a PET study25 suggests the less the frontal lobes activated (red) during a working memory task, the greater the increase in abnormal dopamine activity in the striatum (green), thought to be related to the neurocognitive deficits in schizophrenia.Actress Clara Bow was diagnosed with schizophrenia in 1949.
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Schizophrenia

Schizophrenia is a severe mental illness characterized by persistent defects in the perception or expression of reality. A person experiencing untreated schizophrenia typically demonstrates grossly disorganized thinking, and may also experience delusions or auditory hallucinations. more...

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Although the illness primarily affects cognition, it can also contribute to chronic problems with behavior or emotions. Due to the many possible combinations of symptoms, it is difficult to say whether it is in fact a single psychiatric disorder; and Eugen Bleuler deliberately called the disease "the schizophrenias" (plural) when he coined the present name.

Diagnosis is based on the self-reported experiences of the patient, in combination with secondary signs observed by a psychiatrist or other competent clinician such as a doctor of psychology. There is no objective biological test for schizophrenia, though studies suggest that genetics and biochemistry are important contributing factors. Current research into the development of the disorder often focuses on the role of neurobiology, although a reliable and identifiable organic cause has not been found. In the absence of objective laboratory tests to confirm the diagnosis, some question the legitimacy of schizophrenia's status as a disease.

The term "schizophrenia" translates roughly as "shattered mind," and comes from the Greek σχίζω (schizo, "to split" or "to divide") and φρήν (phrēn, "mind"). Despite its etymology, schizophrenia is not synonymous with dissociative identity disorder, also known as multiple personality disorder or "split personality"; in popular culture the two are often confused. Although schizophrenia often leads to social or occupational dysfunction, there is little association of the illness with a predisposition toward aggressive behavior.

Overview

Schizophrenia is often described in terms of "positive" and "negative" symptoms. Positive symptoms include delusions, auditory hallucinations and thought disorder and are typically regarded as manifestations of psychosis. Negative symptoms are so named because they are considered to be the loss or absence of normal traits or abilities, and include features such as flat, blunted or constricted affect and emotion, poverty of speech and lack of motivation. Some models of schizophrenia include formal thought disorder and planning difficulties in a third group, a "disorganization syndrome."

Additionally, neurocognitive deficits may be present. These may take the form of reduced or impaired psychological functions such as memory, attention, problem-solving, executive function or social cognition.

Onset of schizophrenia typically occurs in late adolescence or early adulthood, with males tending to show symptoms earlier than females.

Psychiatrist Emil Kraepelin was the first to draw a distinction between what he termed dementia praecox ("premature dementia") and other psychotic illnesses. In 1911, "dementia praecox" was renamed "schizophrenia" by psychiatrist Eugen Bleuler, who found Kraepelin's term to be misleading, as the disorder is not a form of dementia, premature or otherwise.

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From famine, schizophrenia: starvation gives birth to personality disorder
From Science News, 8/6/05 by B. Harder

Women who go severely hungry during early pregnancy face twice the normal risk of having a child who develops schizophrenia in adulthood, shows a study of the prevalence of the personality disorder among people who were born in China before, during, and after a 2-year famine that began in 1959.

The results confirm observations from a famine in Holland during the winter of 1944-1945. The high rate of schizophrenia associated with the Dutch famine, caused by a Nazi blockade, could have been explained by food shortage or other factors. For example, many starving Dutch people ate tulip bulbs, which might contain some neurotoxin.

The Chinese famine followed abrupt changes in agricultural practices instituted by the Communist government and, except for the scarcity of food, shared few similarities with the Dutch crisis. Malnutrition, therefore, appears to explain the increased incidence of schizophrenia in both famines, says Richard Neugebauer of the New York State Psychiatric Institute in New York City, who has studied the Dutch famine.

In the new research, David St. Clair of the University of Aberdeen in Scotland and his collaborators analyzed records from 1956 to 1965 of births and deaths in and around Wuhu, China. The investigators also looked for diagnoses of schizophrenia in hospital records covering 1971 to 2001. The study's long follow-up period enabled the researchers to identify people who developed schizophrenia even as adults.

They found that of the children born in 1960 and 1961 about 2 percent became schizophrenic by age 40 or 41. Just under 1 percent of the children born during other years of the study developed the disorder by 2001--a rate that's consistent with worldwide data suggesting an overall 1 percent incidence of schizophrenia.

The data support the prevailing notion that early pregnancy is a crucial period for famine-associated schizophrenia, the researchers report in the Aug. 3 Journal of the American Medical Association. Children conceived in Wuhu in the months before the famine began, but born during the famine, avoided excess risk of schizophrenia. However, children conceived toward the end of the famine and born after it had ended faced increased jeopardy.

Neither the Dutch nor the Chinese study indicates how prenatal malnutrition contributes to schizophrenia. Calorie shortage or lack of some specific nutrient could be responsible. There's "suggestive, provocative evidence" that folate deficiency elevates risk, Neugebauer says, so supplements of that vitamin might prevent delayed epidemics of schizophrenia in famine-affected regions. "Prevention is a real possibility in the context of prenatal care," he says.

COPYRIGHT 2005 Science Service, Inc.
COPYRIGHT 2005 Gale Group

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