Saturday, December 8, 2007

Is Schizophrenia a “Psychotic Disorder”?

Some researchers say that the “mental” illness called “schizophrenia” or “schizoaffective” might not really be a “psychotic disorder” since even after treating the psychosis, the person is generally left with severe impairments in function.

It has been proposed (by Henry A. Nasrallah, MD and other schizophrenia researchers) that schizophrenia might better be classified as a neurodevelopmental/neurodegenerative disorder characterized by a deficit syndrome and cognitive dysfunction, with intermittent secondary psychotic episodes [1] rather than as a "mental" illness, or a "psychotic disorder".

An example of a "neurodevelopmental" label is "autism". It is also an example of an underused term -- neurobiological (brain) disorder which includes Tourette syndrome as well. An example of "neurodegenerative" is "Huntington's" or "Alzheimer's".

But there seems to be a multitude of illnesses getting lumped into the diagnosis of “schizophrenia”, as long as the medical causes are not known. There may indeed be people manifesting symptoms of psychosis due to some emotional problems. I certainly cannot make that judgment call. But as it is, very little goes into the very many physical reasons for psychosis, while a huge industry revolves around "mental".

Some of these are due to problems in mitochondria [2] some are strange complex genetic disorders, the baby’s own genes influencing it’s wiring en-utero[3] or the mother’s immune response to flu or other infections while pregnant[4] or even stress responses influencing the wiring of the developing baby’s brain[5] and many are other physical illnesses that could have been diagnosed if only they had been tested for[6].

All those medical illnesses can cause psychotic symptoms yet they are not called "psychotic disorders". If schizophrenia might not be a "psychotic disorder" either, than It does leave one to wonder what exactly IS a "psychotic disorder"?

Related Links:
Related Books:
[1] "Is Schizophrenia a Psychotic Disorder?" in Current Psychiatry Online Vol. 6, No. 12 / December 2007)
[2] Here are just three of many studies in which “schizophrenia” comes from a biological problem with mitochondrial DNA: Psychiatric comorbidity in 36 adults with mitochondrial cytopathies. CNS Spectr. 2007 Jun ; 12( 6): 429-38 New variants in the mitochondrial genomes of schizophrenic patients. Eur J Hum Genet . 2006 May ; 14(5): 520-8 Mitochondrial DNA HV lineage increases the susceptibility to schizophrenia among Israeli Arabs. Schizophr Res. 2007 Jun 11 ;
[3] Genetic Variation Helps To Understand Predisposition To Schizophrenia American Society for Biochemistry and Molecular Biology (2007, August 10). Genetic Variation Helps To Understand Predisposition To Schizophrenia. ScienceDaily.
[4] "Maternal immune activation alters fetal brain development through interleukin-6" Journal of Neuroscience 2007.
[5] “Prenatal teratogens and the development of adult mental illnessDevelopment and Psychopathology (1999), 11: 457-466
[6] There is such a long list for this one, including people I know, that I’ll just leave you with one reference case: “After 3 months, she’s still ‘mad’Current Psychiatry Online, 2007 April.  

Property of:
Last Updated:     26 August 2011 

No comments: