정신분열증은 치료 가능한 생물학적 증후군입니다. 현재 사용 가능한 약물과 담당 의사 및 치료 팀의 지원으로 정상적이고 만족스러운 삶으로 돌아갈 수 있는 희망이 있습니다.

정신 분열증이란 무엇입니까? (PDF)

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

신드롬

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.

뇌 장애

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.”

정신분열증 증후군에는 수백 가지의 "생물형"이 있지만 모두 유사한 표현형의 정신병, 인지 결핍 및 음성 증상을 공유합니다.

정신분열증의 임상양상

정신분열증은 세계 인구의 약 1%(전 세계 6천만 명)에게 영향을 미칩니다.

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.

약물

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.

정신 분열증에 대한 오해

정신분열증의 전형적인 증상은 뉴스 매체의 선정적인 이야기와 매우 다를 수 있습니다. 언론은 때때로 정신분열증 환자를 공감이 불가능하거나 위험하거나 약하다고 잘못 묘사합니다. 환자가 경험할 수 있는 것은 정신분열증이 실제로 있다고 생각하는 것과는 매우 다릅니다.

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 아름다운 마음) 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.

정기적으로 약물을 복용하고 약물을 남용하지 않는 조현병 환자는 위험하지 않습니다. 실제로 통계적으로 조현병 환자는 일반 인구보다 더 위험하지 않으며, 범죄의 가해자보다 피해자가 될 가능성이 더 높습니다. 반사회적 성격 장애는 범죄자에게 훨씬 더 흔한 장애이며 정신분열증과 달리 범죄와 밀접한 관련이 있습니다.

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.

정신분열증 이론

정신분열증의 실제 병리학에 대한 수많은 이론이 있으며 이는 유사한 임상적 특징을 공유하는 정신분열증의 생물학적 하위 유형이 수백 가지에 이르기 때문입니다. 대체로 태아기 동안의 뇌 발달 장애는 이 증후군의 생물학적 기반입니다. 두 가지 뇌 신경 전달 물질이 정신분열증의 기초에 중심적인 역할을 하는 것으로 생각됩니다. 글루타메이트 NMDA 수용체 신경전달물질 경로의 저활동성은 많은 증거에 기초한 정신분열증의 선도적인 이론이며, 정신분열증에서의 도파민 과잉활동은 사실 글루타메이트의 낮은 활성 때문일 수 있습니다. 정신분열증이 글루타메이트 NMDA 활동의 감소로 인한 것일 수 있다는 가장 강력한 증거 중 일부는 남용 약물인 PCP 또는 엔젤 더스트가 건강한 사람을 정신분열증과 구분할 수 없는 정신 질환을 가진 사람으로 변형시킬 수 있다는 것입니다. 양성, 음성 및 인지 증상을 포함합니다. PCP는 글루타메이트 NMDA 수용체의 매우 강력한 차단제입니다.

회복

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.

정신분열증이 뇌의 질병이라는 점을 강조하고 다른 신경학적 뇌질환과 비교함으로써 정신분열증의 낙인은 결국 사라질 가능성이 매우 높습니다. 정신분열병에 대한 낙인은 이해 부족과 비합리적인 두려움의 해로운 결과이며 심각한 신경 정신 장애로 고통받는 개인에게 매우 사기를 떨어뜨릴 수 있습니다. 일반 대중은 정신분열증이 있는 사람들에게 심장병이나 암과 같은 다른 모든 의학적 상태를 가진 사람들에게 확장된 동일한 연민, 수용 및 이해를 보여주어야 합니다.

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.

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