Cognizance of Schizophrenia:: A Profound Insight into the Psyche

313 Pages·2023·3.926 MB·English

by  Indranath Chatterjee

Indranath Chatterjee   Editor
Cognizance
of Schizophrenia:
A Profound
Insight into the
Psyche
Cognizance of Schizophrenia: A Profound Insight
into the Psyche
Indranath Chatterjee
Editor
Cognizance of Schizophrenia:
A Profound Insight into
the Psyche
Editor
IndranathChatterjee
DepartmentofComputerEngineering
TongmyongUniversity
Busan,Korea(Republicof)
ISBN978-981-19-7021-4 ISBN978-981-19-7022-1 (eBook)
https://doi.org/10.1007/978-981-19-7022-1
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Preface
Everwonderwhatyoucanaskapersonlivingwithschizophrenia?Unfortunately,it
isnotverycleartoanswerthisquery.Theconsciousnessofthemindofschizophre-
niapatientsiscomplicated.Schizophreniapatientssometimesbecomeverydelicate
andsensitive.Variousthoughts,visions,andvoicesarebeingperceivedwithintheir
brain.Havingalonghistoryofthedisorder,schizophreniaisstillconsideredasevere
mentalillness,majorlyachronicpsychologicaldisorder.Althoughcontroversiesare
there to consider it a neuro-psychological disorder, neuroscientists, clinicians, and
interdisciplinaryresearchersarethrivingtocomprehenditcompletely.
Asmentioned,schizophreniaisacomplexbraindisorder,wherevariousaspects
arebeinginvestigatedforitscognizance.Startingfromepigeneticstochemistryand
physics to computational approaches, the scope of research on schizophrenia is
never-ending. There are several things in this book we are covering to help the
readerswithprofoundknowledgeofschizophreniafromeverypossibleaspect.This
bookelaboratesonthekeyconceptsofschizophreniafromvariousaspectssuchas
neurogenetics, neurochemistry, neuropharmacology, neurobiology, psychotherapy,
psychiatrictreatment,cognitivestudy,braindynamics,andcomputationalneurosci-
ence. This book explains each section and chapter with utmost clarity to maintain
comprehensiveness for every kind of reader. This book covers various classical as
well as recent topics from basic to advanced level knowledge regarding
schizophrenia.
Thisbookwillindeedoutperformmostoftheavailablebooksonthemarket.The
book’s contributions regarding its inclusivity of topics, comprehensiveness of lan-
guage, diversity in knowledge, and focus on the subject will attract all kinds of
readers. It can be considered a single comprehensive handy reference book for
beginners, including medical students, neuroscientists, researchers, clinicians, and
medicalpractitioners.Tomentionafewcorepointstoproveitsoutperformanceover
anyothercompetitivebook,thefollowingcanbeconsidered:
v
vi Preface
1. Writteninsimplelanguageforunderstandingacrosstheglobe.
2. Topicsareeasilyexplainedwithexamples.
3. A smooth flow of content while shifting from primary to advanced topics for
betteradaptationofreaders’minds.
4. Adeepstudyofthetopics.
5. Writteninastraightforwardmethodforeasycomprehensiveness.
6. A single book on schizophrenia comprises various aspects to understand the
illnessfromeverydirection.
7. Discussiononstate-of-the-arttechniqueswillinspirefutureresearchers.
Thefollowingmajortopicsarecoveredinthisbook:
(cid:129) Neurogenetics:Roleofgeneticsinthedevelopmentandfunctionofthenervous
systeminschizophreniapatients.
(cid:129) Neurochemistry: Interface between genetics, brain pathology, and chemical
interactionsinthebrainofschizophreniapatients.
(cid:129) Neuropharmacology:Implicationofdrugsandchemicalcompoundsinthebrain
ofschizophreniapatients.
(cid:129) Psychotherapy: Discussing treatments of schizophrenia using psychotherapy
such as intensive cognitive-behavioral therapy and routine care supportive
counseling. It will also discuss complementary psychotherapy for patients such
asmusictherapy,arttherapy,andothers.
(cid:129) Clinicalpsychiatrictreatment:Itwilldiscusstheadministrationofantipsychotics
andclinicalinterventionofschizophreniapatients.
(cid:129) Neuroimaging and computational neuroscience: This will throw light on the
scope of the study of schizophrenia in terms of computational approaches and
medicalimagingtechniques.
(cid:129) Socialneuroscience.
(cid:129) Cognitiveneuroscienceandmanymore.
Chapter 1 introduces the fundamental concepts of schizophrenia. When traced
back, it was found that cognitive and psychological disorders were reported fre-
quently in history. Symptoms of schizophrenia initially were compared and were
confused as dementia and were tossed with the same. However, schizophrenia
remained an enigma until the early 1900. This chapter introduces the various
perspectivesofthedisorderinallaspectsaswellasstatestherecentadvancements
inallspheresforthediagnosisandtreatmentofschizophrenia.
Chapter2focusesongeneticmutationsandalternativesplicinginschizophrenia.
ThechaptertriestoexplainallpossibleRNAmis-splicingrelatedtoschizophrenia.
Itlistssomegenesandtheirtypesofsplicing,thepositionofexon-intronskipping,
intron retention, alternative promoter, exon inclusion, etc. Transcriptomic analysis
demonstrated the genetic risk of schizophrenia in the human brain by using short-
readRNA-sequencing.
Chapter 3 describes how the chemical interaction changes in the brain during
schizophrenia,alsohowduetochangesinthechemicalinteractionsthestructureof
thebrainchanges.
Preface vii
Chapter4describesthediagnosticperspectiveofschizophreniafromthepastto
thepresent.Itisamentalillnesscharacterizedbyacombinationofsymptomssuchas
perceptualmisinterpretation,cognitiveimpairment,andemotionaldysfunction.
Chapter5describesvariousbiologicalconditionstoidentifyadisorderasschizo-
phreniaornot.Thesymptomsofschizophreniaarebroadlydividedintotwotypes:
PositiveandNegativesymptoms.Inthischapterwehavecoveredfivemajormental
disorderswhichsharesomeoftheothercommoncharacteristics.Wehaveselected
SZD, Alzheimer’s disease, Parkinson’s disease, chronic depression, and bipolar
disorder. Starting from their definition to its severity we have highlighted different
characteristics like biological, psychological, and cognitive characteristics of SZD
andhowitisdifferentfromotherdisorders.Whereverpossiblewehavealsolinked
morethantwodisordersandwaystodifferentiatethemfromeachother.
Chapter 6 describes the neurobiological aspects of Schizophrenia and the Rela-
tionship between neurological disorders such as depression, anxiety, and epilepsy.
Thisstudy identifiestheissueneurobiologicallymore than pathologically or medi-
cally as we know. Firstly, schizophrenia causes the nervous system and brain
functions such as the cerebrum, cerebellum, white matter, and gray matter. These
phenomena are associated with neurotransmitters occurrence even, like dopamine,
glutamate, etc. Secondly, depression and anxiety disorder have comparable symp-
tomsphysicallyandmentally.
Chapter 7 states the clinical treatments available for schizophrenia. In this
chapter, a combination of all guidelines which is currently followed worldwide is
highlighted. To start any treatment, initial assessment of the patient is very impor-
tant. Following assessment, the aim should the correct diagnosis of schizophrenia.
Multiple types of treatment options are available for schizophrenia like pharmaco-
logical, ECT, and non-pharmacological. Pharmacological management mainly
includesvarioustypesofantipsychotics,antidepressants,andbenzodiazepines.
Chapter 8 provides insights into the neuropharmacological treatment of schizo-
phreniafromthepast,present,andfuture.Here,wedescribethekeymeta-analytic
evidence on the efficacy of antipsychotics in the acute treatment of schizophrenia,
particularly clozapine in treatment-resistant patients. In this chapter, primarily we
focus on the neuropharmacological treatment options available for schizophrenia
andhowhasthetreatmentchangedovertime.
Chapter 9 explains the management of schizophrenia from the clinician’s per-
spective. The pathophysiology of schizophrenia is not completely understood yet;
hencethereisnodefinitivetreatmentforthedisorder.Antipsychoticshavebeenthe
mainstayforthemanagementofschizophreniasincethebeginning.Antipsychotics
arebroadlyclassifiedintotypicalandatypicalantipsychotics.Alltheantipsychotics
areassociatedwithextrapyramidalParkinson-likesideeffects,moresowithtypical
antipsychotics. Psychotherapy is the newer option for targeting especially the neg-
ative symptoms of schizophrenia. Among psychotherapeutic approaches, the most
successfulapproachtodateiscognitive-behavioraltherapy.
Chapter 10 states the pharmacotherapy and emerging treatment strategies for
schizophrenia. Recognizing the clinical manifestations of schizophrenia early is
essential.Itiscaused bygenetic factors,alterations intheneurotransmitter system,
viii Preface
mitochondrial dysfunction, immunological variables, and psychological issues.
Apart from these causes, traumatic events in childhood or particularly cannabis
consumption during adolescence (a critical phase in the development of the brain)
may influence the disease’s origin, progression, and relapse risk. Initiating early
treatmentimmediatelyaftertheinitialepisodeofpsychosisisimportantforrecovery.
The patients usually require long-term treatment. There are multiple medications
availablefortreatingandmanagingsymptomsassociatedwithschizophrenia.
Chapter11discussesthealternativetherapiesavailableforschizophrenia.People
withschizophrenialivealowqualityoflifebecauseofunfortunateclinicalconsid-
erations, vagrancy, joblessness, monetary constraints, and inadequate funds to pay
for medicals, ignorance, lack of formal education, and unfortunate interactive
abilities or social interaction. Because of the amalgamation of various top-notch
antipsychoticprescriptions,anincredibleheadwayinitstreatmenthasbeenmadein
the last century. This chapter aims to make known and consider the importance of
alternative and corresponding strategies and methods in the treatment of
schizophrenia.
Chapter 12 states the different phases of schizophrenia patients: from the psy-
chological perspective. The primary purpose of this chapter is to review current
clinical staging information in schizophrenia spectrum disorders. In the last two
decades,clinicalstaginghasbeenintegratedintopsychiatry.Itsmajorpurposeisto
categorizethedisorder’sprogressionintodistinctphasesbasedonseverity,progres-
sion,anddiseasefeaturestobetteranticipateoutcomesaswellaschooseappropriate
therapeuticinterventions.
Chapter 13 states the stigmatizing attitudes towards patients with schizophrenia
among medical professionals and the general population. For this study, data was
taken from a group of Nonpsychiatric Doctors with over 10 years ofexperience in
their field, a group of the general population having a minimum qualification of a
bachelor’sdegree,andfrompsychiatristshavingaminimumqualificationofanMD
in Psychiatry. A total of 28 responses from nonpsychiatric Doctors, 27 responses
from the educated general population, and 20 responses from psychiatrists were
obtained.Thereweresignificantdifferences(witha95%levelofconfidence)inthe
meansofstigmatizingattitudestowardspeoplewithschizophreniaamongPsychia-
trists,NonpsychiatricDoctors,andtheGeneralPopulation.Noticeablestigmatizing
attitudeswerealsoseeninmentalhealthprofessionals.
Chapter14talksabouttherehabilitationofschizophreniaandpracticalinterven-
tions.Thecurrentstudywasconductedonanindividualwithschizophreniawhohad
acognitiveandsocialdeficit.Theconclusionwasmadebasedontheresultsofthe
MMSE to determine the impact of Psycho-Social interventions of CBR in the
community. The improvement in the score of cognitive deficit is compiled with
thesatisfactionofthepatientandfamilymembers.
Chapter15statestheconsumptionofCannabisanditsriskfactorsasatherapeutic
agent forpatientswith schizophrenia. Theconsumptionofcannabishasrepeatedly
been linked to the occurrence of psychosis and subsequently, conversion into
schizophrenia. The factors that affect the relationship between cannabis use and
schizophreniaaredose,ageofonset,gender,geneticpredisposition,environmental
Preface ix
risk,andcomorbidsubstanceuse.Manystructuralandfunctionalalterationsoccurin
thecentralandperipheraltissuesbecausecannabinoidreceptorsarestimulatedthat
are found all over the central nervous tissues and in some peripheral tissues.
Schizophrenia patients who smoke cannabis have a greater chance of recurrence,
extendedhospitalstays,andexhibitextremepositivemanifestations.
Chapter 16 describes the state-of-the-art applications of medical imaging for
schizophrenia. In this chapter, we have addressed one of the disorders associated
withthehumanbrain,knownasschizophrenia.Itisapsychoticdisorderthatmakes
thepersoninterpretthingsaroundtheenvironmentabnormally.Inthenextsection,
wehaveenlightenedschizophreniaandmedicalimagingrelations,varioustypesof
neuroimaging techniques including CT scan, MRI (magnetic resonance imaging),
fMRI (functional MRI), PET (positron emission tomography), and comparison
amongthem.Also,wehavediscusseddifferentmachinelearninganddeeplearning
frameworksandtechniquesusedinthisarea.Finally,wehaveconcludedourchapter
withthefuturescope,upcomingchallenges,andconclusions.
Chapter 17 explains schizophrenia and its effect on marital satisfaction. This
chapteraimstoexplorehowschizophreniacanaffectone’smaritalsatisfactionand
how marriage canaffect anyindividualdiagnosed withschizophrenia.Thechapter
alsoaimstounderstandtherelationshipsharedbetweenspousesandtheparent-child
dynamicwiththeparent being diagnosedwithschizophrenia.Thehighlight ofthis
chapter is that we try to understand marital satisfaction in individuals with schizo-
phrenia through the perspective of Sternberg’s Triangular Theory of Love. The
theory discusses relationships through the help of 3 aspects: Intimacy, Passion,
andCommitment.
Chapter18statesthemortalityrateofschizophrenia.Thepeoplediagnosedwith
severementalillnesshavea10–20yearslowerlifespancomparedtonormalpeople.
Schizophrenicpatientshavealso15yearsoflesslifeexpectancyaspernewresearch
studies.Onestudydonein2015foundthatpatientswithschizophreniaarethreeand
halftimesmorelikelytodieinthegivenyearthanpeopleinthesameagegroup.To
reducethemortalityamongschizophrenicpatients,modifyingfactorslikeexercise,
diet, and substance abuse can be addressed along with the support of family
members. The stigma of mental illness and social and economic status play a
significant influence on survival and the standard of living among schizophrenic
patients.
Busan,RepublicofKorea IndranathChatterjee
8July2022
Contents
1 UnderstandingSchizophrenia:IntroductoryAspect
oftheMentalDisorderfromVariousPerspectives. . . . . . . . . . . . . 1
IndranathChatterjee
2 GeneticMutationsandAlternativeSplicinginSchizophrenia. . . . . 15
NamrataRambhauJawanjalandIndranathChatterjee
3 UnderstandingtheChemicalInteractionsintheBrain
ofSchizophreniaPatients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
VideshaBansalandIndranathChatterjee
4 ADiagnosticPerspectiveofSchizophrenia:FromPast
toPresent. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
MeghnaR.ChoudhariandIndranathChatterjee
5 IsItSchizophreniaorNot?DifferentBiological
Characterization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
VideshaBansal
6 NeurobiologicalAspectsofSchizophreniaandRelationship
BetweenNeurologicalDisorders:Depression,Anxiety,
andEpilepsy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
HyejoonPark
7 ClinicalTreatmentAvailableforSchizophrenia. . . . . . . . . . . . . . . 95
PapiyaGhosh
8 InsightsintotheNeuro-PharmacologicalTreatmentof
Schizophrenia:Past,Present,andFuture. . . . . . . . . . . . . . . . . . . . 113
ShilpaChatterjeeandRajendraPrasadChatterjee
9 ManagingSchizophrenia:AChallengeforPhysicians. . . . . . . . . . . 127
NimraMumtazandMuhammadOmairHassan
xi