VÍDEO: Fatos da Esquizofrenia Baseados na Ciência

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

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.

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.”

Existem centenas de “biótipos” dentro da síndrome da esquizofrenia, mas todos compartilham um fenótipo semelhante de psicose, déficits cognitivos e sintomas negativos.

A esquizofrenia afeta cerca de 1% da população mundial (60 milhões de pessoas, em todo o mundo).

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.

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.

Os sintomas típicos da esquizofrenia podem ser muito diferentes das histórias sensacionalistas da mídia. A mídia às vezes retrata erroneamente as pessoas com esquizofrenia como impossíveis de se relacionar, perigosas ou fracas. O que um paciente pode experimentar é muito diferente do que eles pensavam que a esquizofrenia realmente é.

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 Uma Mente Brilhante) 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.

Pessoas com esquizofrenia que tomam seus medicamentos regularmente e não abusam de drogas NÃO são perigosas. Na verdade, estatisticamente, as pessoas com esquizofrenia não são mais perigosas do que a população em geral e têm maior probabilidade de se tornarem vítimas do que perpetradores de crimes. O transtorno de personalidade antissocial é um transtorno muito mais comum em criminosos e está fortemente associado à criminalidade, ao contrário da esquizofrenia.

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.

Existem inúmeras teorias da patologia real na esquizofrenia e isso porque provavelmente existem centenas de diferentes subtipos biológicos de esquizofrenia, que compartilham características clínicas semelhantes. De um modo geral, o desenvolvimento cerebral interrompido durante a vida fetal é a base biológica dessa síndrome. Dois neurotransmissores cerebrais são considerados centrais para a base da esquizofrenia. A hipoatividade da via do neurotransmissor do receptor NMDA do glutamato é uma das principais teorias da esquizofrenia com base em muitas linhas de evidência, e a hiperatividade da dopamina na esquizofrenia pode, de fato, ser devida à baixa atividade do glutamato. Algumas das evidências mais fortes de que a esquizofrenia pode ser devida à atividade reduzida da atividade NMDA do glutamato é que o PCP, ou Angel Dust, que é uma droga de abuso, pode transformar uma pessoa saudável em alguém com uma doença psiquiátrica indistinguível da esquizofrenia. incluindo sintomas positivos, negativos e cognitivos. O PCP é um bloqueador muito potente do receptor NMDA do glutamato.

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.

Ao enfatizar que a esquizofrenia é uma doença do cérebro e compará-la com outras doenças cerebrais neurológicas, é muito provável que o estigma da esquizofrenia possa eventualmente desaparecer. O estigma em relação à esquizofrenia é uma consequência prejudicial da má compreensão e do medo irracional e pode ter um efeito muito desmoralizante nos indivíduos que sofrem deste grave distúrbio neuropsiquiátrico. O público em geral deve mostrar às pessoas com esquizofrenia a mesma compaixão, aceitação e compreensão que é estendida a pessoas com todas as outras condições médicas, como doenças cardíacas ou câncer.

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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