Is Schizophrenia associated with Physical Abnormality in the Brain?
There have been dramatic advances in neuroimaging technology that permit scientists to study brain structure and function in living individuals. Many studies of people with schizophrenia have found abnormalities in brain structure (for example, enlargement of the fluid-filled cavities, called the ventricles, in the interior of the brain, and decreased size of certain brain regions) or function (for example, decreased and increased metabolic and neurotransmitter activity in different brain regions). It should be emphasized that these abnormalities are quite subtle and are not characteristic of all people with schizophrenia, nor do they occur only in individuals with this illness. Microscopic studies of brain tissue after death have also shown small changes in distribution or number of brain cells in people with schizophrenia. It appears that many (but probably not all) of these changes are present before an individual becomes ill, and most of what we know about schizophrenia centres on neurodevelopmental abnormalities.
Stress, arising from sudden events like a car accident, bereavement or moving home, may occur shortly before an episode of schizophrenia, and, though it is not the cause, it almost certainly acts as a ‘trigger’. Long-term stress, such as family tensions, may also make it worse.
At one time, it was fashionable to believe that schizophrenia was created by particularly disturbed families, but there is no evidence to support this idea. Families do not cause schizophrenia. However it does tend to run in families. A child who has an affected parent has a 1 in 10 chance of developing schizophrenia. Viral infections during pregnancy, birth complications, growing up in inner cities and drug misuse also seem to play a part in the development of schizophrenia. The structure and chemistry of the brain may be affected, but there are no simple diagnostic tests for this at present.
Evidence from research suggests that an event such as stressful time or difficult relationship in the family can sometimes trigger an episode of schizophrenia in someone who is already likely to develop it because of genetic and other factors. Anyone can get the symptoms of schizophrenia. People with it may read special meanings into things they see around them. They may feel that everything is wonderful and important, or frightening and strange.
We don’t know exactly what causes these feelings. It is a highly complex disorder resulting from the interactions between multiple environmental and genetic factors. The pervasive nature of the symptoms means that schizophrenia affects the whole person, and possibly the rest of their life, from the outset.
