統合失調症は治療可能な生物学的症候群です。現在入手可能な薬物療法と、医師や治療チームのサポートにより、通常の充実した生活に戻る希望があります。

ビデオ:統合失調症 科学的根拠に基づく事実

統合失調症とは? (PDF)

Although currently classified as a mental illness, schizophrenia is also scientifically accepted as a neurobiological brain condition.

Aシンドローム

Schizophrenia, a neurobiological brain syndrome, includes possibly hundreds of distinct brain diseases. These diseases are sometimes referred to as “schizophrenia spectrum disorders.” Symptoms vary greatly among different people. The most widely accepted theory of schizophrenia is that it is a neurodevelopmental disorder, which means that normal brain development during fetal life or later is disrupted due to various genetic factors and/or environmental factors.

Schizophrenia usually first manifests in adolescence or early 20s in males and in the late 20s and sometimes early 30s in females.

脳の病気

While schizophrenia is clearly a neurological disorder along with stroke, Parkinson’s disease, Alzheimer’s disease and others – schizophrenia is still classified as a mental illness. It should be emphasized that one of the most important jobs of the brain is to generate the mind, and thus all mental disorders such as schizophrenia, bipolar disorders, major depression or panic disorder are actually caused by abnormalities in brain structure and function.  As Thomas Insel, MD – and former Director of the National Institute of Mental Health – said, “Mental disorders are biological disorders involving brain circuits.”

統合失調症には何百もの「バイオタイプ」がありますが、いずれも精神病、認知障害、陰性症状という表現型は共通しています。

精神分裂病の臨床的特徴

統合失調症は、世界人口の約1%(全世界で6,000万人)が罹患していると言われています。

Symptoms of schizophrenia may include hallucinations (seeing, hearing or smelling things that are not really there) and delusions (persistent false beliefs, such as believing they are a member of the CIA or that someone wants to harm them). These symptoms are referred to as “positive symptoms” though they are not positive to the person experiencing them. (“Positive” refers to manifestations of disrupted human thinking, perceptions and behavior.) These symptoms are attributed to increased activity of the neurotransmitter dopamine in a certain region of the brain.

Social withdrawal, lack of interest in things a person used to love, and loss of interest in self-care (such as not eating or showering) are considered “negative” symptoms of schizophrenia. (“Negative” refers to loss or decrement of normal human social or personal functions.) Some of these symptoms are known to be associated with a reduction of the same neurotransmitter dopamine in the frontal region of the brain, affecting the ability to be motivated, display normal facial expressions, or to initiate an action.

Cognitive impairment is another important aspect of the illness that includes memory deficits and inability to plan or make decisions. Additionally, patients with schizophrenia often do not realize they are sick and resist being hospitalized or refuse medications that can help them. This lack of insight is quite common in schizophrenia. Medications as well as counselling can help patients develop awareness that they do have a medical illness and that they should adhere to their medication in order to achieve remission and ultimately recovery.

While a complete list of schizophrenia symptoms may be extensive, most patients experience some but not all of these symptoms. It may even be difficult for one person with schizophrenia to understand and relate to what another person with schizophrenia is experiencing. For example, a patient with hallucinations may find it hard to imagine how it would feel to experience paranoia, or voices of one patient may not resonate with the voices of another.

薬物治療

Schizophrenia medications that reduce or eliminate symptoms of schizophrenia like hallucinations and delusions are called antipsychotics. Examples available today include risperidone, olanzapine, quetiapine, and aripiprazole. Clozapine is an antipsychotic that can work when several others fail to control the psychotic symptoms.

Some people with schizophrenia experience full recovery (becoming asymptomatic, or nearly asymptomatic) and work, or continue to pursue higher education. A sizeable proportion will have at least partial recovery and may be able to function at some level in the community. These people may choose to not disclose their schizophrenia, because of common misunderstandings of schizophrenia, and the unfair stigma associated with it.

統合失調症への誤解

精神分裂病の典型的な症状は、ニュースメディアのセンセーショナルな記事とは全く異なる場合があります。メディアは時に精神分裂病の患者を人間関係がうまくいかない、危険、弱いといった誤ったイメージで描いています。患者が経験することは、精神分裂病が実際にそうであると思っていたこととは全く異なるのです。

Common myths of schizophrenia include the erroneous idea that people with schizophrenia have multiple personalities, a split mind, or a low IQ.

Schizophrenia is completely different from multiple personality disorder, and does not represent a flawed personality. Anyone, including highly intelligent persons (such as the mathematician and Nobel Prize winner John Nash featured in 美しい心) and people of any socioeconomic status or race can develop it. Like cancer, diabetes, autism, and other medical problems, it cannot be simply overcome by willpower.

薬を定期的に服用し、薬物を乱用しない精神分裂病の患者さんは危険ではありません。実際、統計的に見ても、精神分裂病患者は一般人と比べて危険ではなく、犯罪の加害者になるよりも被害者になる可能性の方が高いのです。反社会的人格障害は、統合失調症とは異なり、犯罪者にはるかに多く見られる障害であり、犯罪性と強く関連しています。

It is also important to note that the suicide rate in schizophrenia is high and second only to the suicide rate in major depression. However, antidepressants can help reduce the suicide risk, as can clozapine which is approved by the FDA for suicidality in schizophrenia.

統合失調症に関する理論

精神分裂病の実際の病態については数多くの説がありますが、それは精神分裂病にはおそらく何百もの異なる生物学的亜型が存在し、それらが類似の臨床的特徴を共有しているからです。大まかに言えば、胎児期の脳の発達の乱れがこの症候群の生物学的基盤である。精神分裂病の基盤には2つの脳神経伝達物質が中心となっていると考えられています。グルタミン酸NMDA受容体の神経伝達経路の活性低下は、多くの証拠に基づく統合失調症の有力な説であり、統合失調症におけるドーパミンの過剰活性は、実際にはグルタミン酸の活性低下によるものである可能性があります。統合失調症がグルタミン酸NMDA活性の低下によるものである可能性を示す最も有力な証拠は、乱用薬物であるPCP(エンジェルダスト)が、健康な人を、陽性、陰性、認知症状など統合失調症と区別のつかない精神疾患を持つ人に変えてしまうというものである。PCPは、グルタミン酸のNMDA受容体を非常に強力に遮断する。

リカバリー

The psychotic symptoms of schizophrenia are quite treatable. However, there are still no known treatments for the negative symptoms and cognitive deficits of schizophrenia. There is no shame in having schizophrenia, or in taking a medication for it, or for any other medical illness. Schizophrenia is no one’s fault, any more than asthma, an infection, hypertension, diabetes, arthritis, or cancer is anyone’s fault.

精神分裂病が脳の病気であることを強調し、他の神経学的な脳の病気と比較することによって、精神分裂病に対するスティグマはやがて消えていく可能性が非常に高いのです。統合失調症に対するスティグマは、貧しい理解と不合理な恐怖がもたらす有害な結果であり、この深刻な神経精神疾患に苦しむ人々に非常に意気消沈させる効果をもたらします。一般市民は、心臓病や癌など他のすべての病状を持つ人々と同じように、精神分裂病患者にも思いやり、受け入れ、理解を示すべきです。

Today, on medication, full recovery from schizophrenia is possible, especially with clozapine, a medication approved by the FDA for hallucinations and delusions that do not improve with any of the dozen other antipsychotic drugs available in the United States. Clozapine is also the only medication approved by the FDA for suicidal tendencies in schizophrenia, which is quite common.

ご質問はございませんか?私たちの医師に聞いてください こちら.
もっと見たい?詳細はこちら 統合失調症の最新研究.