New research shows that schizophrenia is not a single disease, but a cluster of eight distinct disorders, each of which is caused by changes in clusters of genes that eventually lead to different sets of symptoms. The study was published in the American Journal of Psychiatry.
Joe wakes up to shadows and their loud voices almost every day. The numbness wears off sometime between sleep and awake, and he is seeing red everywhere. What normally appears as shadows are not shadows at all, but red blobs consisting of gigantic teeth and fierce claws. The ground he stands on begins to heave, the walls bend and bulge and a storm carries him up into the air. Suddenly, the whole world seems to be bleeding!
So, what is going on inside the mind of Joe? Joe lives in a unique world when it comes to matters of 'mind', a private world which is totally different from those inhabited by others Reality is vastly and vaguely different from others for him. He has a tough time making sense of incoming stimuli, making it impossible to focus on seemingly simple activities. Imagine a sand castle with all the sand sliding away in the receding surf. So in the end, there's no center to take things in and process them. Joe suffers from a debilitating disease called as schizophrenia; wherein he has hallucinations and delusions and is unable to sort, interpret or respond appropriately to stimuli.
People with schizophrenia may see or hear things that actually don't exist, speak in strange or confusing ways, constantly think that others are trying to harm them, or feel like someone is keeping an eye on them. In response, people with schizophrenia may become quite anti-social and withdraw from the outside world and life in general might become very difficult.
According to the American Psychiatric Association, schizophrenia is a chronic brain disorder that affects about 1% of the population. Symptoms experienced by the patients can vary from hallucinations to disordered speech to attention and decision-making problems.
Researchers from Washington University in St. Louis studied and analyzed the DNA of more than 4,000 people who suffered from schizophrenia. The study participants' individual symptoms were matched with any gene variations which they found in DNA. The university released a statement saying that in doing so they found several "gene clusters" that appear to cause eight distinct classes of schizophrenia.
The study authors wrote "Complex diseases, such as schizophrenia, may be influenced by hundreds or thousands of genetic variants that interact with one another in complex ways,"
One of the senior authors, Dr. C. Robert Cloninger, explained "Genes don't operate by themselves. They function in concert much like an orchestra, and to understand how they're working, you have to know not just who the members of the orchestra are but how they interact."
Going by the results of the past studies done on twins and families, the authors say that about 80% of the risk for schizophrenia is inherited i.e., if one identical twin has schizophrenia, for example, there is an 80% chance that the other twin would also suffer from the same disease. A recent study revealed as many as 108 genes may be tied to the mental health disorder, but scientists did not identify the specific genetic variations that put people at risk.
The scientists at Washington University looked at instances where a single unit of DNA was altered, which is known as a single nucleotide polymorphism (SNP). They later identified 42 interactive SNP sets that significantly increased people's risk of schizophrenia as per the study. In other words, if study participant Bob had Gene Cluster X, then he was 70% more likely to have schizophrenia as compared to study participant Fred who didn't have that cluster of genes. Certain gene clusters were matched with close to a 100% increase in risk in few cases.
One of the co-authors, Dr. Dragan Svrakic explained "In the past, scientists had been looking for associations between individual genes and schizophrenia. What was missing was the idea that these genes don't act independently. They work in concert to disrupt the brain's structure and function, and that results in the illness."
Dr. Charles Raison, a professor of psychiatry at the University of Arizona says that the notion of schizophrenia not being one single disorder is not really new. He added "Schizophrenia is probably 80 different diseases. All psychiatric conditions are likely to share this heterogeneity. There are only so many ways that certain malfunctions in your genetic code can manifest. There may be 10 separate gene mutations, but they might only express themselves as one or two symptoms. So what's causing hallucinations in one person might be different than what's causing them in another."
The study marks a breakthrough for scientists and the findings sets the stage for them to develop better ways to diagnose and treat schizophrenia. It also provides clarity to promote widespread understanding of this devastating mental illness.
Types of schizophrenia:
Paranoid schizophrenia: It involves either suspicion or delusions (erroneous beliefs involving a misinterpretation of experiences or perceptions) or auditory hallucinations (voices distinct from a person's own thoughts). Delusions are predominantly grandiose, following a single theme such as persecution, jealousy, religion, etc.
Catatonic schizophrenia: In this type of schizophrenia, the person becomes extremely immobile, unresponsive, withdrawn and may assume unusual body positions.
Disorganized schizophrenia: This type involves different types of disorganization in speech and behavior. When asked, the person generally gives answers which are not pertaining to the topic. They exhibit child-like behavior. It affects the person's ability to perform daily activities such as preparing meals, showering, dressing etc.
Residual schizophrenia: In this kind of schizophrenia, the patient usually loses all motivation or interest in life even though he is no longer experiencing delusions or hallucinations.
Schizophrenia is a disabling brain disorder that has affected many people throughout history. However the positive aspect is that the outlook for the disorder continues to improve with a strong support network of friends and families; thus many people with schizophrenia are able to control their symptoms and even lead fulfilling lives.