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1、SchizophreniaWhatcausesschizophrenia?NeuropathologyStructuralandfunctionalchangesNeurochemicalalterationsTreatmentsSchizophreniaEmilKraepelin“DementiaPraecox’(1896)Blueler“Schizophrenia”Onset:adolescenceoryoungadulthoodDSM-IVreview:Positivesymptoms(delusions,hallucinations,di
2、sorganizedspeechorbehavior)Negativesymptoms(catatonia,affectiveflattening,withdrawal,oravolition)Social-occupationaldisturbance6+monthsAssociatedFeaturesCognitiveDisturbancesMemorySensoryfilteringAttentionEmotionrecognitionEye-trackingInterpersonalDysfunctionSubtypesCatatonic
3、ParanoidDisorganizedUnlikelytobearelatedtoasinglephysiopathologyNeuropathologyNeurodevelopmentalhypothesisNeurodegenerativehypothesisDopaminehypothessisGlutamatergichypothesis**ThesearenotexclusiveWhatcausesschizophrenia?Heritable(Shastry,2002)EnvironmentalfactorsEpidemiologi
4、calstudiesBirthcomplicationsMaternalstressSeasonalityeffectViralepidemicsLatitudeeffectRhincompatibilityNeuropathology StructuralalterationsBehavioralsymptomsindicativeofbraindamage(unusualratesofblinking,poorcontrolofeyemovements,unusualfacialexpressions)Enlargedventricles(W
5、einberger&Wyatt,1982;Andreason)VentricularenlargementinmonozygotictwinwithschizophreniaBarondes,1993HippocampalvolumelossandenlargedventriclesVanHeronetal.,2005Neuropathology Structuralalterations(cont)Alterationsinnumerousareas,includingfrontallobes,medialtemporallobes,later
6、altemporallobes,parietallobe,basalganglia,corpuscallosum,thalamusandeventhecerebellumWhitematterdeficitsEvidenceofdisorganizedneuronsandfailuresofmigrationAltereddensityanddisorganizationofneuronsfoundinthewhitematterbelowlayerVIinthecortexDisorganizedpyramidalcellsinthehippo
7、campusAltereddevelopmentofhippocampalpyramidalneuronsNeurodevelopmentalHypothesisHomemoviesfromfamilieswithschizophrenicchilddisplayedabnormalbehavior(Walkeretal,1994;1996)ChildrenwholaterbecomeschizophrenicexhibitpoorsocialadjustmentandschoolperformanceDevelopmentaldelaysPre
8、morbidpsychopathology(anxiety,depression,conductdisorders,ADHD)(Kim-
