SCHIZOPHRENIA EPIDEMIOLOGY & PATHOGENESIS

SCHIZOPHRENIA EPIDEMIOLOGY & PATHOGENESIS


SCHIZOPHRENIA EPIDEMIOLOGY & PATHOGENESIS

EPIDEMIOLOGY:

  • Prevalence – 1 % 
    • Equal in men & women.
    • High heritability (Increased familial prevalence).
    • More prevalent in lower socioeconomic status.
  • Incidence rate – 0.15-0.25 per thousand.
  • Onset age – 
    • Adolescence and young adulthood.
      • Earlier onset in men
    • Late onset schizophrenia (After 45 yrs).
  • Predisposing factors:
    • Body types: Asthenic (thin & weak).
ETIOLOGY:
Genetic factors:
  • Higher monozygotic concordance rate.
  • Important nine linkage sites: 1q, 5q, 6p, 6g, 8P, 10p, 13q, 15q & 22q.
Genes involved:
  • Alpha-7 nicotinic receptor
  • DISC I (Disrupted in schizophrenia)
  • COMT (catechol-o-methyl transferase)
  • NRG 1 (Neuregulin 1)
  • GRM-3 (Glutamate receptor metabotropic)
  • RGS-4 (Regulator of G protein signalling)
  • DAOA (or G-72) (D-Amino acid oxidase activator)
Biochemical factors:
  • Dopamine: Excess of dopaminergic activity.
  • Serotonin – Increased responsible for symptoms.

Neuropathological factors:

  • Abnormalities in structures including,
    • Cerebral ventricles, limbic system, prefrontal cortex, thalamus, basal ganglia & cerebellum.

Exam Important

  • Schizophrenia has high heritability.
  • The usual age of onset of schizophrenia is adolescence and young adulthood.
  • After age of 45 years, the disorder is called late-onset schizophrenia.
  • Asthenic (thin and weak) individuals are believed to be predisposed for development of schizophrenia.
  • According to “Dopamine hypothesis”, excess dopaminergic activity is responsible for schizophrenia.
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