Schizophrenia is more common in
which socioeconomic strata ?
a) Middle
b) Upper
c) Low
d) Upper middle
Correct Answer - C
Ans. is ‘c’ i.e., Low
'Schizophrenia is more prevalent in patients having a lower
socioeconomic status". - Namboodiri
Etiology of Schizophrenia
The exact etiology is not clear. Experts think schizophrenia is
caused by several factors.
- Heredity (Genetic factors)
Schizophrenia runs in families. The illness occur in 0.5-1% of
general population. However, First degree relative of schizophrenic
patients have a 10 times more lifetime risk of having illness. The risk
is 3-6 times and 2 times more in second and third degree relatives,
respectively - Environmental factors
Environmental factors and stress are important in precipitating
schizophrenia in many individuals. These factors are : ? - Socioeconomic : - Low socio-economic status, Industrialization;
Immigration; familes with high expressed emotions; Nuclear families;
Schisms & skewed families; and pseudomutul & pseudohostile
families. - Drugs : - Drugs causing schizophrenia like state are amphetamine
(most common causative drug), LSD, Phencyclidine, ketamine,
Mescaline, Cocaine, Cannabis. - Metabolic & Neurological disorders : - Schizophrenia like symptoms
may occur in Huntington’s chorea (early stage), homocystinuria,
acute intermittent porphyria, Wilson’s disease and
hemochromatosis. - Biochemical factors
Dopamine hypothesis is the most accepted hypothesis for
schizophrenia. There is hyperactivity of dopaminergic system. This
hypothesis is supported by: 1) Amphetamine and cocaine which
release dopamine in central synapses induce schizophrenia like
symptoms; and 2) Antipsychotic drugs control the schizophrenic
symptoms by blocking dopamine (D,) receptors. However, the
dipamine hypothesis has been questioned also as Homo vanillic
acid (HVA the principal metabolite of dopamine) is not elevated and
prolactin level is not decreased (Dopamine has inihibitory action on
prolactin release).
Other neurotransmitters involved are : - Increased serotonin,
Decreased GABA, variable change (Increased or decreased)
glutamate, and increased norepinephrine