ESPB2043 INTRODUCTION TO PHYSIOLOGICAL PSYCHOLOGY

Titles: Schizophrenia

Prepared for: Madam Sofia Binti Elias

Group members:

• Farah Najwa Binti M Nazri (MC230120156)

• Putri Nuralea Aniera Binti Saleh (MC230120573)

• Aida Syahirah Binti Nizam (MC230120220)

• Amashita Binti Ramshide (MC230120157)

• Ain Nadia Binti Kasikin (MC230120861)

1.0 Introduction

Schizophrenia is a chronic brain disorder that affects how a person thinks, feels and behaves which is

suffered by 7.7- 43.0 per 100,000 Malaysian populations and majority of them are unemployed.

Schizophrenia patients may seem like they have disconnected with reality, which can be stressful for

them and surrounding people along with considerable disability, affecting the education and

occupation functioning. This illness may result in some combination of hallucinations, delusions,

disorganized speech, lack of motivation and extremely disordered thinking and behaviour that impairs

daily functioning, making it difficult to participate in usual, everyday activities resulting from fear,

suspicion, agitation, and depression. However, effective treatments are available which require a long

period of time for the recurrence to be diminished. Research has shown that schizophrenia affects

both men and women equally but most of the cases, males will have earlier onsets than females.

Schizophrenia patients tend to die younger than the general population due to high rates of co-

occurring medical conditions.

2.0 Causes

Schizophrenia is a serious and persistent mental illness that has an impact on a person's thoughts,

feelings, and actions. Although the precise origin of schizophrenia is unknown, research indicates that
a mix of genetic, environmental, and brain chemistry variables may be to blame. We shall go more

into the aetiology of schizophrenia in this answer.

Genetic influences. Studies have demonstrated that there is a large hereditary component to

schizophrenia. A person is more likely to acquire schizophrenia themself if they have a close

family who has the condition. People who have a first-degree relative with the illness, such as

a parent or sibling, have a 10% greater chance of getting schizophrenia than the general

population. The condition is assumed to be the result of a complex interaction of hereditary

and environmental variables, thus it's vital to emphasise that genetics alone do not cause

schizophrenia.

Environmental factors. The onset of schizophrenia can be significantly influenced by

environmental circumstances. The condition has been connected to a number of

environmental variables. problems throughout pregnancy and after birth. During pregnancy or

after delivery, exposure to illnesses, hunger, or other stresses may raise the chance of

developing schizophrenia. traumatised childhood. Childhood trauma, abuse, or neglect have

been related to a higher risk of schizophrenia development. addiction to drugs. Abuse of

drugs, especially cannabis and amphetamines, has been associated with a higher risk of

schizophrenia. upbringing in a city. Growing up in an urban setting has been linked to a higher

chance of developing schizophrenia, potentially as a result of more exposure to

environmental stressors or social stresses.

Brain chemistry factors. schizophrenia is thoughts to be caused by an imbalance in the

brain’s neurotransmitters, which are chemicals that allow nerve cells to communicate with

each other. The neurotransmitters that have implicated in schizophrenia include dopamine,

glutamate, and serotonin. Imbalances in these neurotransmitters can disrupt the brain’s

normal functioning and lead to the symptoms of schizophrenia.

Irregularities in the brain's structure. Studies have revealed that the prefrontal cortex,

hippocampus, and amygdala in particular exhibit structural abnormalities in the brains of

persons with schizophrenia. These anomalies could already exist at birth or could appear

later in life as a result of environmental influences. Schizophrenia symptoms can result from

anatomical abnormalities that interfere with the brain's capacity to process information.
3.0 Symptoms

Schizophrenia is a widely known disorder in the Psychology world. Though it has been discovered

ages ago, the symptoms remain the same. Throughout history, most popular beliefs for Schizophrenia

patients are that they were known to be a danger to themselves and society. However, with the

correct treatments and medications as well as follow ups, it has been proven that patients do get

better.

One of the obvious signs or symptoms for a schizophrenia patient is delusion. Delusion is described

as the false belief that is not associated with reality. Patients who experienced delusions may be

seen as distraught and obsessive as they behave in a way that is out of norms. One of the common

delusions that patients almost always described is they believed that they are being harassed or

harmed by someone. By harassed means including stalking, threats and even the feeling of being

chased. Other than that, the second most common delusion is that when patients believed that a

certain someone is in love or obsessed with them. This commonly happened with celebrities. The

obsession on the belief system that a certain public figure is in love with them can lead to harm on

that certain public figure. Harm almost includes stalking and trespassing as well as death threats. One

of the most famous examples is when public figure, Miley Cyrus was harassed by Mar Mcleod who

claimed he received a secret message from the star through TV.

Next symptom would be by hallucination. One of the common symptoms that is well known for

Schizophrenia patients is also the top symptoms that exhibits in patients itself. Hallucinations without

control can be very dangerous towards societies as well as the patients itself. Imagine taking

hallucinogenic drugs almost all the time that comes without warning. That is what most patients

describes their hallucination. There were some individuals that were known for their hallucination.

Most times, patients were able to control and differentiate between reality and hallucinations. But in

some cases, patients mostly cannot distinguish properly when it comes to auditory hallucinations.

Auditory hallucinations can be triggered by multiple reasons hence for them to not be able to realise

that they were hallucinating.

Next would-be disorganized thinking or speech. This can cause effective communication to be

impaired which makes patients harder to communicate with others and ended up being an outcast.

Most common example for patients to exhibit this symptom is for example, by answering questions
unrelated to the topic itself. Or the most common as well is by exhibiting word salad. Where they

scramble words and speak incoherently.

Besides speech, they will also exhibit extremely disorganised motor behaviour where they sometime

may act like a child to unpredictable agitation or triggers. It also proven that they would show

resistance to instructions, inappropriate or bizarre posture, lack of response and excessive

movement. These behaviours are what it meant as the childlike silliness. This can also cause the

society to look down upon patients that have schizophrenia.

Finally, they would also exhibit negative symptoms or to be known as depression. They would have

the lack of ability to function normally and lose interest in daily activities. These symptoms although

may be common, but not all schizophrenia patients will exhibit all of the above symptoms. Some might

only have a few and it is measured by the DSM measurement.

4.0 Diagnosis

Schizophrenia is a mental illness marked by delusions, hallucinations, and/or disorganised speech

that significantly impairs functioning and causes severe distress. It is classified as a chronic mental

disorder with a 3 to 7 percent lifetime prevalence. According to the Diagnostic and Statistical Manual

of Mental Disorder, Fifth Edition (DSM-5), to meet criteria of schizophrenia:

A. Characteristic symptoms: Two or more of the following, each present for a significant portion

of the time for 1 month period (or less if successfully treated);

1. Delusions

2. Hallucinations

3. Disorganized speech (e.g., frequent derailment or incoherence)

4. Grossly disorganized

5. Negative symptoms

B. Social/occupational dysfunction:

The level of functioning in one or more important areas, such as employment, interpersonal

relationships, or self-care, has been significantly below the level achieved before the
 disturbance started for a sizable period of time (or when the onset is on childhood or

adolescence, there is failure to achieve expected levels of interpersonal, academic, or

occupational functioning).

C. Duration:

For at least six months, there are persistent signs of the disturbances. This 6-month period

may contain prodromal or residual symptoms for up to 1 month (or less if successfully treated)

and must include at least 1 month of active phase symptoms that meet Criterion A. Merely

negative symptoms or two or more of the symptoms described in Criterion A may be present

during this prodromal or residual period as the indications of disturbances.

D. Substances/general medical condition exclusion:

The disturbance is not attributable to the physiological effects of substances (e.g., a drug

abuse, a medication) or another medical condition.

The doctor may request more tests, such as an MRI scan or blood test, to help make a diagnosis.

 Imaging scan – CT scan, MRI, etc to rule out problem changes in brain structure.

 Blood, urine, and CSF test – To rule out chemical changes in bodily fluid that might explain

changes in behaviour.

 Brain activity test – Electroencephalogram (EEG) detects and records electrical activity in

brain disorder. When diagnosing brain illnesses, particularly epilepsy or another seizure

disorder, an EEG can identify variations in brain activity. An EEG could be useful for

identifying or treating:

 brain cancer

 head injury-related brain damage

 Many conditions can lead to brain dysfunction (encephalopathy)

 sleep problems

 inflamed brain tissue (herpes encephalitis)

 Stroke

 sleep problems

 Alzheimer's disease
 A chronic coma patient's brain death may also be verified using an EEG. For a patient in a

coma that has been medically induced, a continuous EEG is utilised to determine the

appropriate level of anaesthetic.

4.1 An Assessment of Five commonly used Symptoms Rating Scales in Schizophrenia.

I. Positive and Negative Syndrome Scale (PANSS)

The most common are still the scales used to measure positive and negative

symptoms in schizophrenia. Clinicians and academics continue to primarily assess

and diagnose schizophrenia using scales measuring positive and negative

symptoms. This test has a reputation as the ‘gold standard’ for measuring how well

your treatment is working. Doctor will interview about 30-40 minutes with patient and

family members.

First session – Regarding medical history and symptoms.

Second session – Doctor will find out how severe your symptoms.

Third session – Focused questions such as “how train and bus are alike?” to check

how well the patient can reason. The patient will also get question about mood.

II. SANS and SAPS Test

Two test to analyse the effect of positive and negative symptoms. Scale for the

Assessment of Negative Symptoms, or SANS, is its name. It assesses 25 detrimental

signs of schizophrenia, such as:

 lack of expressions on the face

 Lack of social awareness

 lack of ties and interests

Scale for the Evaluation of Positive Symptoms is how the SAPS test is officially

known. 34 positive symptoms are examined, including:

 Hallucinations (the perception of unreal sounds or images)

 Delusions (strong convictions about untrue things)

III. Brief Psychiatric Rating Scale (BPRS)

 For assessing a patient's level of schizophrenia, it's one of the most used tests that

psychiatrists employ. The assessment evaluates 18 signs or actions, including

aggression, confusion, and hallucinations. The evaluations are based on a 20–30

minutes conversation between patient, family, or other carers and doctor.

IV. Clinical Global Impression – Schizophrenia (CGI-SCH)

This test for schizophrenia patients has been modified by psychiatrists from the

broader Clinical Global Impression score, which is used to identify other psychiatric

conditions. Similar to the PANSS test, doctors typically utilise CGI-SCH to evaluate

the effectiveness of a schizophrenia treatment for an individual or group of

participants in a clinical trial. The CGI-SCH can be calculated by a psychiatrist in just

a few minutes, in contrast to other tests that need a long interview with predetermined

questions. During the consultation, you will be asked about your symptoms from the

previous week. Two things are measured by the CGI-SCH:

 what level of schizophrenia you have.

 what level the symptoms have altered since your last examination.

V. Calgary Depression Scale for Schizophrenia.

This exam is used by doctors to check for depression symptoms that could disrupt

your daily life or possibly cause you to contemplate suicide.

5.0 Progressions

Schizophrenia has three phases which are prodromal, active, and residual. The diagnosis phase is

crucial for a patient to get a proper treatment to control their health condition. Schizophrenia is an

incurable mental illness that has been affected people worldwide and this illness not only affect the

way people think but also their feelings and behaviour. they may have experience delusions,

hallucinations, depression, memory problems and disorganized thought and speeches.

These people can control their symptom with the help of other people such as doctors and nurses.

With the help of medical team and treatment from them, these patients can get an effective treatment.

However, without treatment and medications, patients with schizophrenia effect their ability in work or

school, live independently, or having a relationship with other people. This patient has not only

experienced those life change, but also go through as below:

  Delusions  Depression

 Hallucinations  Memory problems

 Disorganized thoughts and speech

1. Prodromal stages

There are few stages progression of schizophrenia. It is called prodromal stages, active stages

and lastly residual stages.

The initial stage of schizophrenia, it takes place prior to the onset of obvious psychotic symptoms.

A person has behavioural and cognitive alterations throughout this phase which may eventually

lead to psychosis. On this stage as well, normally other symptoms will occur with other mental

illness such as depressions.

Other symptoms of prodromal schizophrenia are included such as below:

 Social isolation  Lack of motivation

 Anxiety  Irritability

 Difficulty concentrating  Changes to one’s normal routine

 Sleep problems  Neglecting personal hygiene

 Erratic behaviour  Mild or poorly formed hallucinations

2. Active stages

The second stage of schizophrenia has showed a symptom of psychosis including hallucinations,

delusions, and paranoia. Active psychosis or schizophrenia occur with such symptoms:

 Hallucinations including seeing, hearing,  Delusions in which are false notions or

smelling, or feeling things that others do ideas that a person believes even when

not presented with evidence to the contrary

 Confused and disorganized thoughts  Disordered or jumbled speech

 Excessive or useless movement  Wandering

 mumbling  Laughing to oneself

  Apathy or numbing of emotions

3. Residual stages

The last stage of schizophrenia is residual stages whereby the patients has been experiencing

less or severe symptoms than in active stages. Normally, on this stage, they do not experience

any positive symptoms such as hallucinations or delusions, but this stage is more or less related

to prodromal stage and experiencing negative symptoms such as lack of motivations, low energy

and depressing mood.

Other symptoms of residual schizophrenia are included as below:

 Social withdrawal  Difficulty concentrating

 Difficulty planning and participating in  Reduced or absent facial expressions

activities

 Flat, monotone voice  General disinterest

6.0 Treatment with drugs

One of the main crucial treatments for schizophrenia were antipsychotic medication. These prescribed

drugs are used to control the brain neurotransmitter dopamine from affecting. There are a few types of

examples of medications that can be used on patients depending on different doses. The purposes of

this treatment with antipsychotic medication to control those symptoms and signals when they were at

the low doses as possible.

Each patient will be used different drugs or doses or possible combinations between those two to

receive an accurate result. Besides that, not only prescribed drugs will be used on them but also other

medications such as antidepressants or anti-anxiety drugs. Because of that, the result may take

several weeks to see any other symptoms on schizophrenia patient. Other than that, with several

medications or prescribed drugs that been used in schizophrenia patients, it can cause a side effect.
Sometimes it can be very difficult for them to take those drugs. For those patients who always refuse

to take medications, they will be given an injection as they will becoming aggressive.

There are two types of medications that were used such as first generations antipsychotics and

second-generations antipsychotics. The differences between these generations are the first

generations are created with a side effect that are very difficult to control and in some cases it is

irreversible. Meanwhile, the second generations were created with the intended to avoid those side

effect. Between these two generations has a common risk such as dyslipidaemia, weight gain,

metabolic syndrome and lastly diabetes mellitus. There are few ways to discover this information but

most important is to consult with a doctor about the benefits and side effect of any medications.

These second generations medications are main preferred by the doctor is because they are

exposed to a lower risk of seriousness side effect than the first generations antipsychotic.

Second-generations antipsychotic are included such as below:

 Aripiprazole (Abilify)  Asenapine (Saphris)

 Brexpiprazole (Rexuy lti)  Cariprazine (Vraylar)

 Clozapine (Clozaril, Versacloz)  Lurasidone (Latuda)

 Olanzapine (Zyprexa)  Paliperidone (Invega)

 Quetiapine (Seroquel)  Risperidone (Risperdal)

 Ziprasidone (Geodon)

First-generation antipsychotics

The first-generations antipsychotic is not only cheaper than the second generations but also

has the potential of significant neurological side effect including the possibility of tardive

dyskinesia disorder that may not be changed. These antipsychotics as important as the other

when it comes to the long terms treatment when needed. The first-generations antipsychotics

are included such as below:

 Chlorpromazine  Fluphenazine

 Haloperidol  Perphenazine
 Long-acting injectable antipsychotics

Some antipsychotics may be given as an intramuscular or subcutaneous injections. Normally

they will be given every two to four weeks depending on the medications. These options can

be review together with a doctor if patients have a preference for either pill or needed help at

any time.

Common medications that are available as an injection include:

Aripiprazole (Abilify Maintena, Aristada) Haloperidol decanoate

Fluphenazine decanoate Risperidone (Risperdal Consta, Perseris)

Paliperidone (Invega Sustenna, Invega Trinza) Psychosocial interventions

7.0 Alternatives treatment without drugs

Although currently there is no cure for schizophrenia, it can be treated and manage by medications

and alternative treatments. Two main approaches can be used to treat schizophrenia. There are

pharmacological therapy options available which use antipsychotic medications at varying dosages

depending on the patient and non-pharmacological therapy. The best combination of treatment will be

both alternative. In some cases, schizophrenia can be treated naturally.

Treatment for schizophrenia will focus on controlling your symptoms. It might be necessary to

continue taking medication for a very prolonged period, possibly forever. The approach to assist you

in comprehending and managing your symptoms will probably also include a significant amount of

psychotherapy, a type of talk therapy. The correct treatments, together with practical and emotional

care from loved ones, will go a long way towards assisting the patient in navigating life.

TYPES OF PSYCHOTHERAPY

1. Individual psychotherapy

Referred as a talk therapy. Therapists and psychiatrists provide advice on how to handle

thoughts and behaviours. Find out how to alter one's thoughts to reduce stress.

2. Cognitive Behaviour Therapy (CBT)

 As a result, the person might be able to change their viewpoint and behaviour. A therapist will

teach them coping skills for hearing voices and hallucinating. Using a combination of CBT

sessions and medication, they progressively learn what triggers their psychotic episodes,

which are times when hallucinations or delusions become more intense, and how to lessen or

stop them.

3. Cognitive Enhancement Therapy (CET)

This type of therapy is also known as cognitive remediation. It improves focus, memory, and

mental organisation skills and teaches people how to recognise social signs or triggers better.

Group meetings and computer-based brain training are combined.

PROCEDURE FOR SCHIZOPHRENIA

1. Electroconvulsive therapy (ECT)

In contrast to medication, it can be used to treat schizophrenia as well as depression and

bipolar disorder. In older adults in particular, it acts more quickly within a week. As long as

there is follow-up, this therapy can lower the likelihood of relapse.

How will the process be carried out?

Under general anaesthesia, a procedure in which the brain receives brief electrical shocks to

purposefully cause a seizure is performed. The medical staff will be monitoring on this

process (breathing, heart rate, blood pressure)

Side effect of the procedure

- Confusion

- Temporary memory loss

- Physical discomfort, headaches, muscles aches, nausea etc

2. Transcranial Magnetic Stimulation (TMS-rTMS)

This technique has the potential to effectively cure schizophrenia symptoms, particularly

auditory hallucinations. A session should last between 30 and 60 minutes.

How will the process be carried out?

magnetic coil placed on the forehead, close to the brain region responsible for controlling

mood. The brain is then exposed to a brief electromagnetic pulse from the coil. These pulse-

triggered microcurrents, in turn, excite the nerve cells in that region of the brain.
 As a pulse is given, the person may experience a tiny tapping or thumping feeling on their

head.

Some medical professionals prefer TMS therapy because it targets a more precise region of

the brain than ECT can, minimising side effects.

Side effect of the brain

- Mild to moderate headaches or scalp discomfort

- Tightening of or tingling in muscles of your scalp, jaw, or face during treatment

- Brief light-headedness

- Ear issues caused by the machine’s sounds (earplugs can help)

3. Deep Brain Stimulation (DBS)

This procedure entails a kind of brain surgery exclusively performed on patients who are

unable to manage their symptoms with medication.

The area of your brain where electrodes will be implanted will be studied using an MRI or

another imaging test prior to surgery.

A general anaesthetic will be utilised during brain surgery, and the patient will either be

rendered unconscious or awake with local anaesthesia administered to the scalp.

Your head will be held securely in place by a strong frame.

Second section: General anaesthesia-induced chest wall surgery.

Your heads will have two holes drilled into them by the surgeon, who will then implant a

slanders tube with electrodes on either side of it.

The battery was inserted in the patient's chest, and the surgeon wired up the electrodes that

connect to it. Beginning a few weeks following surgery, the generator is turned on to

continually deliver electrical pulses to the electrodes with the option of turning it off.

Side effect of the procedure

- Stroke during the procedure

- Infection

- Confusion

- Involuntary movement or mood changes

- Light-headedness

4. Vagus Nerve Stimulation (VNS)

 If medicine or ECT have not been successful, your doctor may suggest VNS, which also

entails surgery.

The night before surgery, the patient may need to stop taking their prescriptions and refrain

from eating. A medical examination, blood tests, and maybe taking antibiotics to help avoid

infection after surgery are also performed on you.

After surgery: Typically, a surgery lasts 90 minutes. A local anaesthetic keeps the patient

awake, or they receive general anaesthesia and remain asleep.

Two cuts (incisions) are performed by the surgeon: one on the left side of the neck and one

on the chest or armpit. Afterwards, a pulse generator the size of a stopwatch is implanted in

the chest. The surgeon attaches a cable that is attached to that device to a lengthy nerve that

runs from your brainstem to your chest and abdomen. A few weeks following the procedure,

the surgeon turns on the pulse generator to send electrical impulses (of various lengths and

frequencies) to the nerve, which then communicates with the brain.

Risks associated with a VNS procedure include pain around the surgical incisions, infection,

and temporary vocal cord paralysis. Some possible side effects are:

- Hoarseness and voice changes

- Throat pain and difficulty swallowing

- Coughing

- Headaches

5. Magnetic Seizure Therapy (MST)

MST and TMS are comparable in that they both use magnetic pulses as opposed to electrical

ones. Yet, similar to ECT, it aims to start a seizure, necessitating general anaesthesia and a

muscle relaxant. Medical experts are encouraged by the preliminary findings of MST's testing

for mental problems, which is still in its early phases. Like ECT side effects, except they

disappear faster.

8.0 Statistics

Through various studies and research, psychiatrist and mental health providers throughout Malaysia

have concluded that 7.7 – 43 per 100,000 population have been diagnosed with Schizophrenia and

treated regularly. However, among the numbers, about 70% of patients were left unemployed due to
irregular moods and behaviours. This conclude that 1% of Malaysian population is diagnosed with

Schizophrenia.

Schizophrenia affects approximately 24 million people worldwide or 1 in 300 people which is about

0.32%. It may not be as common as many other mental disorders, however, the number of adults

diagnosed with schizophrenia is enough for researchers and psychologist to reach a certain

hypothesis that can help with the diagnosis of schizophrenia and lessen the symptoms for easier life

for patients. It is known that the country that has the highest rate of schizophrenic patients is from

Indonesia with a total of 829,735 people with the disorder. These studies were taken in 2020.

9.0 Latest research

A recent study conducted by the Icahn School of Medicine at Mount Sinai has made significant strides

in understanding the genetic basis of schizophrenia, one of the most serious mental illnesses.

Schizophrenia occurs in about 1 out of every 100 people and affects how individuals think, feel, and

behave. People with schizophrenia may seem as if they have lost touch with reality, which can be

distressing for them and their families.

The study, which was published in the March 13 online issue of Nature Genetics, identified two

previously unknown genes linked to schizophrenia and newly implicated a third gene as carrying risk

for both schizophrenia and autism. The research was conducted by comparing the gene sequences of

people with schizophrenia to those of healthy controls, involving existing datasets totalling up to

35,828 cases and 107,877 controls. This is the first known work of its kind to investigate

schizophrenia risk across diverse populations, particularly those of African ancestry.

The investigators found the two risk genes, SRRM2 and AKAP11, by focusing on a subset of genes

and discovering rare damaging variants that could potentially lead to new medicines for

schizophrenia. The work builds upon a recent study that identified 10 risk genes for schizophrenia.

However, unlike the current research, the earlier study was conducted in people of predominantly

white European ancestry.

Lead author Dongjing Liu, Ph.D., a former postdoctoral researcher in the laboratory of Alexander W.

Charney, MD, Ph.D., a co-senior corresponding author of the study and Associate Professor of
Psychiatry, Genetics and Genomic Sciences, Neuroscience, and Neurosurgery, at Icahn Mount Sinai,

said, "By focusing on a subset of genes, we discovered rare damaging variants that could potentially

lead to new medicines for schizophrenia." The researchers caution that not every patient has a rare

damaging variant in the identified schizophrenia genes, as the disease is multifactorial and there is no

single factor.

Furthermore, the study demonstrated that the schizophrenia risk conferred by these rare damaging

variants is conserved across ethnicities. The investigators found that rare damaging variants in

evolutionarily constrained genes confer a similar magnitude of schizophrenia risk among different

populations. This finding is significant because genetic factors previously established in predominantly

white people have now been extended to non-whites for this debilitating disease.

The third gene flagged in the study, PCLO, was previously implicated in schizophrenia but is now

identified as having a shared risk for schizophrenia and autism. This finding raises a question about

how we think about brain diseases, suggested Dr. Charney. He stated that "it's been known that there

are genetic components shared among illnesses. Clinically, genes could look different in the same

family. The same variant in the same family may cause autism in one family member and

schizophrenia in another. The idea of the same gene having different manifestations is very

interesting to us, as it could be useful when it comes to treating people in the clinic."

The researchers plan to assess whether and how these genes may have a clinical role and may be

tied to a specific behaviour or symptom of schizophrenia. They will also work to identify drugs that

might target the genes in the study. The ultimate shared goal of the researchers in the field is to

improve patients' lives, and they are grateful to their collaborators who partnered with them on this

effort. The enormous global collaboration and willingness of people to work with the researchers

made this work possible.

In summary, the recent study by the Icahn School of Medicine at Mount Sinai has identified two

previously unknown genes linked to schizophrenia and newly implicated a third gene as carrying risk

for both schizophrenia and autism. This multi-centre study is the first of its kind to investigate

schizophrenia risk across diverse populations and found that rare damaging variants in evolutionarily

constrained genes confer a similar magnitude of schizophrenia risk among different populations.
10.0 Conclusions

Schizophrenia has no absolute cure, but the illness can still be controlled by early diagnosis and

treatment. This mental illness can be caused by genetic influences, environmental factors, brain

chemistry factors and brain irregularities. The symptoms include hallucination, delusions, disorganized

speech, lack of motivation and abnormal motor behaviour. Schizophrenia can be diagnosed by

showing symptoms stated for about 1 month which later the doctor may request more tests such as

an MRI scan, blood test, urine test, CSF test and brain activity test by using the electroencephalogram

(EEG). There are 3 phases in schizophrenia which are prodromal, active and residual stage which

can be controlled with antipsychotic medications and antidepressants. However, there are some

alternatives treatments that do not involve drugs which is called psychotherapy including the talk

therapy, cognitive behaviour therapy (CBT) and cognitive enhancement therapy (CET). The

procedure of schizophrenia includes electroconvulsive therapy (ECT), transcranial magnetic

simulation (TMS-rTMS), deep brain stimulation (DBS), vagus nerve stimulation (VSR) and magnetic

seizure therapy (MST). There are a lot of lifelong therapy for schizophrenia that can control the

patients from misbehaviour but the reoccurrences to be diminished is impossible. Therefore, people

with schizophrenia need a proper care and observation to avoid unwanted incident from happening.
11.0 References

 Schizophrenia Treatment: Types of Therapy and Medications. (2021, March 4). WebMD.

https://www.webmd.com/schizophrenia/schizophrenia-therapy

 Schizophrenia - Diagnosis and treatment - Mayo Clinic. (2020, January 7). Schizophrenia -

Diagnosis and Treatment - Mayo Clinic.

https://www.mayoclinic.org/diseases-conditions/schizophrenia/diagnosis-treatment/drc-

20354449

 Stages of schizophrenia: Symptoms, causes, and treatments. (n.d.). Stages of

Schizophrenia: Symptoms, Causes, and Treatments.

https://www.medicalnewstoday.com/articles/stages-of-schizophrenia

 Researchers identify novel genes that may increase risk for schizophrenia. (n.d.).

Researchers Identify Novel Genes That May Increase Risk for Schizophrenia.

https://medicalxpress.com/news/2023-03-genes-schizophrenia.html

 Schizophrenia. (n.d.). National Institute of Mental Health (NIMH).

https://www.nimh.nih.gov/health/topics/schizophrenia

 Schizophrenia - Symptoms and causes. (2020, January 7). Mayo Clinic.

https://www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-

20354443

 Global Epidemiology and Burden of Schizophrenia: Findings From the Global Burden of

Disease Study 2016. PubMed Central (PMC). Charlson, F. J., Ferrari, A. J., Santomauro, D.

F., Diminic, S., Stockings, E., Scott, J. G., McGrath, J. J., & Whiteford, H. A. (2018, May 12).

https://doi.org/10.1093/schbul/sby058

 39 Schizophrenia Statistics & Facts (Prevalence). (2022, December 14). 39 Schizophrenia

Statistics & Facts (Prevalence). https://www.crossrivertherapy.com/research/schizophrenia-

statistics