Causes of Schizophrenia in Women

A severe form of mental disorder, characterized by specific distortions of thinking and perception, inadequate mood and behavior, can manifest itself in individuals of any sex and at any age. This disease is currently not treated, but in most patients it is possible to slow down its development, and sometimes even alleviate the symptoms. However, the onset of disease manifestation is important for prognosis — an early onset usually indicates a malign process. Sexual differences also occur - in most cases , women have schizophrenia closer to 30 years (later than men), and, accordingly, a less progressive course is characteristic of it. In addition, women are more likely to go to the doctor about mental disorders and respond well to treatment with antipsychotics. Due to these circumstances, the development of the process for a long time, and often - and never, leads to gross personal changes and social exclusion.

Women are great sham-girls and actresses, they tend to invent non-existent diseases for themselves. Even suicidal attempts by women are made more often, although they, unlike men, cannot boast of effectiveness, which suggests the manipulative goal of most of them.

The weak half of humanity is experiencing during its life several serious hormonal changes, and the female psyche is very much dependent on the hormonal background. The mood of a woman sometimes changes drastically over the course of a month depending on the phase of the menstrual cycle, so it is not surprising that women of different age groups are subject to different types of mental disorders.

Girls between the ages of ten and twelve are at risk of developing anxiety disorders combined with hyperactivity and absent-mindedness.

In puberty, there is a high probability of occurrence of deviations from the norm of eating behavior, the most pronounced manifestations of which are anorexia, neurotic vomiting, and overt gluttony. The period of establishment of the menstrual cycle is characterized by a pronounced premenstrual syndrome in the form of dysphoric disorder in some girls. Later increases the risk of developing depression.

The beginning of the sexual life, the first negative experience may result in the development of vaginismus and sexual coldness.

Maternity in some women begins with postpartum depression, sometimes proceeding long and hard.

Climacteric syndrome, which develops after an average of 45 years, is also a risk factor — against its background, anxiety, sexual, somatoform, and other mental disorders can develop.

In old age increases the risk of dementia, drug delirium, depression in the background of the death of a spouse.

Schizophrenia in women occurs less frequently than other mental disorders, but is more severe and can lead to personality degradation. It manifests after stress, substance abuse, in the postpartum period. In childhood and adolescent girls, schizophrenia is rare, but this option cannot be ruled out. Adult women are more likely to have schizotypal personality disorder, previously interpreted as low-progreduced schizophrenia. Currently, these conditions are distinguished precisely because, with similar symptoms, personality disorder does not lead to such destructive consequences as true schizophrenia. The latest edition of the Manual on the Diagnosis and Statistics of Mental Disorders (DSM-5, 2013) recognizes only the most severe of its forms with schizophrenia-like symptoms for more than six months with schizophrenia. Less than this period - schizophrenic disorder, including less than a month - a short-term psychotic disorder. Similar changes are assumed in the next, eleventh, edition of the IBC.

[1], [2], [3]

Cause

Mental disorders in women, risk factors

Schizophrenia and disorders of the schizophrenic spectrum are far from the most frequent mental disorders among the beautiful half of humanity. Far more women experience affective spectrum disorders, eating disorders, phobias and panic conditions. Post-traumatic stress disorders develop in women much more often than in men; depression may even be associated with a change in the time of year.

The origin of schizophrenia is not precisely known; even the term itself is debated as an independent disease, since the positive and negative schizophrenia-like symptoms accompany psychoses of various genesis. The Japanese Society of Psychiatrists at the beginning of this century has already abandoned the diagnosis of "schizophrenia", however, at the moment such authoritative organizations as the American Psychiatric Association and the World Health Organization have not yet come to the conclusion about the need for such changes.

Currently, the findings of scientists about the causes of schizophrenia are in the hypothesis stage and are based on clinical observations of patients with this diagnosis.

Modern methods of neuroimaging allowed to study the characteristics of the brain of patients with schizophrenia during their lifetime, and somewhat lifted the veil of the secrets of the disease. However, the structural features that are found in patients with schizophrenia are devoid of specificity, and most of the findings so far are a statement of the fact that changes in the total brain volume, as well as lesions of individual structures (left temporal lobes, thalamus, prefrontal, occipital cortex and other sites) occur in schizophrenics. But the exact pathogenesis of the disease has not yet been proven.

Prerequisites for schizophrenia in women, as well as in the opposite sex, are due to the presence of genetic predisposition, but the manifestation of the disease occurs under the influence of external causes.

The role of genetic factors is very high, it is confirmed by studies of twin pairs, as well as other relatives of patients who have the same structural changes on tomograms of the brain as in schizophrenic patients, however, are less pronounced. The nature of inheritance is quite complicated, it is assumed the interaction of several mutated genes, as a result of which the risk of developing the disease increases to a critical point. It is assumed that the failure occurs immediately in several metabolic processes occurring in the brain and causing mental changes that fit the diagnosis of schizophrenia. At the same time, genetic changes that are specific for this particular disease have not been identified, and in some cases random gene mutations that are absent from the patient's parents have been the culprit.

Prenatal factors are of great importance in the pathogenesis of the disease. Prenatal infections and other undesirable effects during pregnancy introduce pathological correction in the early stage of neuronal development. Neurobiological studies have suggested that the basis for the development of the disease is the degeneration of neurons, especially the gray matter, and / or neurochemical imbalance, which began even at the stages of intrauterine development.

Some structural abnormalities are already present in the debut of the disease and indicate brain damage that occurred during its formation. For example, the detected violation of the ratios of furrows and convolutions speaks of early developmental deviations, since the folding of the brain is established soon after birth and practically does not change afterwards.

Exogenous risk factors are superimposed on innate predisposition. Among them are considered as living conditions in early childhood, various infectious diseases, and later stressors - various psychological and social interactions. Even the seasonality of birth was studied, and it turned out that among the schizophrenics of the northern hemisphere, most were born in the winter and autumn months.

Among social factors, schizophrenia is a disease of urban dwellers, and a higher degree of urbanization increases the likelihood of developing the disease. Other factors - a dysfunctional family, poverty, forced migration, loneliness, emotional and physical mockery in childhood, and repeated similar episodes at a later age increase the likelihood that people with genetically predisposed will develop schizophrenia.

Substance abuse alone can provoke schizophrenia-like manifestations, and sick people often use psychedelic drugs to overcome their characteristic dopamine hunger. Therefore, cause-and-effect relationships in such cases are monitored with difficulty, and if it is known for certain that the patient is an alcoholic or drug addict, he is not diagnosed with schizophrenia, but interprets this case as a withdrawal syndrome or severe intoxication.

The specific risk period for women is pregnancy and the postpartum period. In predisposed women at this particular time, associated with changes in hormonal and social status, can manifest schizophrenia.

Psychological risk factors are also multiple. Reactions in patients with schizophrenia show their hypersensitivity to negative stressful stimuli, therefore, various exciting situations are perceived very emotionally and can trigger the development of the disease.

The neuronal mechanisms are degraded with the disease, especially the frontal, temporal parietal lobes, hippocampal areas, the connections between them are damaged, the parallel orientation of the white matter fibers is reduced. This leads to a violation of executive functions and verbal memory, impulsive behavioral reactions. Other brain structures are also affected, however, it is mainly people who have been ill for a long time and are receiving antipsychotic therapy. In some cases, it leads to the normalization of certain structures, for example, the basal ganglia, however, and causes side effects in the form of circulatory disorders and structural deformations. And while it is difficult to separate the contribution to the created violations, provoked by drugs.

Against the background of new opportunities, many neurotransmitter theories of the origin of schizophrenia have emerged - kinurerenic, dopamine, GABA-ergic and others. Essentially, all processes of transmission of nerve impulses are affected, but so far none of the hypotheses can reliably explain the structural changes occurring in schizophrenia and the pathogenesis of the development of the disease.

Almost all of the risk factors are considered: smoking and a sedentary lifestyle, alcoholism and drug addiction, pharmacotherapy leading to loss of brain volume, high physical activity in patients with schizophrenia, on the contrary, causing an increase in the volume of the hippocampus. Many changes in the structure are reversible under the influence of drug therapy, however, all this is still being studied and, perhaps, in the near future, schizophrenics can really help to overcome their illness.

[4], [5], [6], [7], [8], [9], [10]

Epidemiology

Statistics

It is known statistics that for the entire period of life the probability of becoming ill with schizophrenia is equal to 1%, however, research conducted at the beginning of our century reduced this figure by almost half (0.55%). Predisposition increases the probability of getting sick up to 10-15% in cases of illness of one of the closest blood relatives of the first line (mother, father, siblings), both parents - up to 40-50%. If more distant relatives are sick (uncle's aunts, grandparents, cousins, and others), the probability is estimated at about 3%.

The peak incidence in the weaker sex falls on the age group from 26 to 32 years. In men, this gap occurs earlier (20-28 years). At a young age, there are many more male patients, but by the age of 40 women start to catch up with them and as a result it turns out that the chances of getting sick do not have gender differences. On average (late schizophrenia) and advanced (very late) age, the incidence is low, but its probability cannot be excluded. The prevalence on a global scale is uneven, it is well established that the urban population is sick much more often and the lifestyle associated with a high level of urbanization is considered one of the risk factors.

[11], [12], [13], [14]