视频：精神分裂症的科学事实

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.”

精神分裂症综合征中有数百种“生物型”，但它们都具有相似的精神病表型、认知缺陷和阴性症状。

精神分裂症影响了世界上大约 1% 的人口（全世界 6000 万人）。

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.

精神分裂症的典型症状可能与新闻媒体中耸人听闻的故事大不相同。媒体有时会错误地将精神分裂症患者描绘成无法与之相处、危险或虚弱的人。患者可能经历的与他们认为的精神分裂症实际上是非常不同的。

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 美丽的心灵) 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.

定期服药且不滥用药物的精神分裂症患者并不危险。事实上，从统计数据来看，精神分裂症患者并不比一般人群更危险，他们更容易成为受害者而不是犯罪者。与精神分裂症不同，反社会人格障碍在罪犯中更为常见，并且与犯罪密切相关。

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.

关于精神分裂症的实际病理学有许多理论，这是因为精神分裂症可能有数百种不同的生物学亚型，它们具有相似的临床特征。从广义上讲，胎儿期大脑发育受损是该综合征的生物学基础。两种大脑神经递质被认为是精神分裂症基础的核心。谷氨酸 NMDA 受体神经递质通路的活性不足是基于许多证据的精神分裂症的主要理论，精神分裂症中的多巴胺过度活性实际上可能是由于谷氨酸活性低。一些最有力的证据表明精神分裂症可能是由于谷氨酸 NMDA 活性降低所致，PCP 或 Angel Dust 是一种滥用药物，可以将健康人转变为患有与精神分裂症无法区分的精神疾病的人，包括阳性、阴性和认知症状。 PCP 是一种非常有效的谷氨酸 NMDA 受体阻滞剂。

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.

通过强调精神分裂症是一种脑部疾病，并将其与其他神经性脑部疾病进行比较，精神分裂症的污名很可能最终会消失。对精神分裂症的污名化是缺乏理解和非理性恐惧的有害后果，它会对患有这种严重神经精神疾病的人产生非常沮丧的影响。公众应该向精神分裂症患者表现出对患有心脏病或癌症等所有其他疾病的人同样的同情、接纳和理解。

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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