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Schizophrenia Information > Cognitive Behavioral Therapy for Psychosis and Schizophrenia

Schizophrenia is a disorder of the brain
(as is Bipolar Disorder / Manic Depressive)

Brain images, Brains of Normal Control Males compared to brains of Males w/Schizophrenia

Source: Laboratory of Neuro Imaging, University of California, Los Angeles,

For more pictures of the disease process of schizophrenia see below, and also: Neuro Imaging of the impact of the disease process of schizophrenia


Written by: Dr. E. Fuller Torrey (Note: schizophrenia.com has added the photos and some of the more recent medical research references in this article)

History of the Scientific View on Schizophrenia as a Brain Disorder: It has been suspected for over a century that schizophrenia and manic-depressive disorder (bipolar disorder) are disorders of the brain. In 1837, Dr. W.A.F. Browne, the best-known English psychiatrist of his generation, wrote:

    "Insanity, then, is inordinate or irregular, or impaired action of the mind, of the instincts, sentiments, intellectual, or perceptive powers, depending upon and produced by an organic change in the brain."

In that same year, Dr. Amariah Brigham, one of the founders of American psychiatry, also wrote that insanity "is now considered a physical disorder, a disease of the brain."

It would be 150 years, however, before these statements could be proven. Since the early 1980s, with the availability of brain imaging techniques and other developments in neuroscience, the evidence has become overwhelming that schizophrenia and manic-depressive disorder are disorders of the brain.

Additional research done during the past decade has revealed that schizophrenia is caused by a combination of genetic or biological predisposition as well as other factors such as prepregnancy factors, pregnancy stress, other prenatal factors, social stress, family stress or environmental stressors during a person's life. Research has now shown that children's and teen's brains are very sensitive to stress (up to 5 to 10 times more sensitive than adult brains) and can be damaged by frequent or ongoing stress.

To learn more about the causes of schizophrenia, and how to prevent it - read these two documents: Causes of Schizophrenia, Prevention of Schizophrenia.

A brief summary of some of the evidence that proves this point follows.

Significant Loss of Brain Gray Matter: Individuals with schizophrenia, including those who have never been treated, have a reduced volume of gray matter in the brain, especially in the temporal and frontal lobes. Recently neuroscientists have detected gray matter loss of up to 25% (in some areas). The damage started in the parietal, or outer, regions of the brain but spread to the rest of the brain over a five year period. Patients with the worst brain tissue loss also had the worst symptoms, which included hallucinations, delusions, bizarre and psychotic thoughts, hearing voices, and depression.

Please note that while there is significant loss of brain gray matter, this is not a reason to lose all hope. In recent (September, 2004) group of presentations and discussion we had with Dr. Daniel Weinberger and other leading National Institute of Mental Health (NIMH) schizophrenia researchers, we learned that there are reasons to believe that this gray matter loss may be reversable. Moreover, the NIMH is currently researching a drug that seems to have potential for reversing the cognitive decline that is caused by schizophrenia, and there are many drug companies also now researching in this area. It is anticipated that we will see some significant announcements related to these develpments in the next few years.


To see more images of brains that are suffering from schizophrenia, go to: Schizophrenia Brain Images. The Image Source is: Laboratory of Neuro Imaging, UCLA, Derived from high-resolution magnetic resonance images (MRI scans), the above images were created after repeatedly scanning 12 schizophrenia subjects over five years, and comparing them with matched 12 healthy controls, scanned at the same ages and intervals. Severe loss of gray matter is indicated by red and pink colors, while stable regions are in blue. STG denotes the superior temporal gyrus, and DLPFC denotes the dorsolateral prefrontal cortex. Note: This study was of Childhood onset schizophrenia which occurs in 1 of every 40,000 people and is frequently a significantly more aggressive form of schizophrenia (than later onset schizophrenia which afflicts approximately 1 of every 100 people).

A Sample of Recent Relevant Research:

Enlaged Ventricles in the Brain: Individuals with schizophrenia, including those who have never been treated, typically have enlarged ventricles in the brain, as demonstrated in over 100 studies to date.

above: MRI imaging showing differences in brain ventricle size in twins - one schizophrenic, one not. (image courtesy NIH - Dr. Daniel Weinberger, Clinical Brain Disorders Branch)

Enlarged Amygdala: Individuals with manic-depressive disorder have an enlarged amygdala and increased numbers of white matter hyperintensities.

    • Strakowski SM, DelBello MP, Sax KW, et al. Brain magnetic resonance imaging of structural abnormalities in bipolar disorder. Archives of General Psychiatry 56:254–260, 1999.
    • Dupont RM, Jernigan TL, Heindel W, et al. Magnetic resonance imaging and mood disorders: localization of white matter and other subcortical abnormalities. Archives of General Psychiatry 52:747–755, 1995.
    • Videbech P. MRI findings in patients with affective disorder: a meta-analysis. Acta Psychiatrica Scandinavica 96:157–168, 1997.

Neurological Abnormalities: Individuals with schizophrenia and manic-depressive disorder, including those who have never been treated, have more neurological abnormalities, as shown in over 25 studies.

Impaired Cognitive Function: Individuals with schizophrenia and manic-depressive disorder, including those who have never been treated, have more neuropsychological abnormalities that impair their cognitive function, including such things as information processing and verbal memory.

A Sample of Recent Relevant Research:

Decreased Prefrontal Brain Function: Individuals with schizophrenia, including those who have never been treated, show decreased function of the prefrontal area, an area of the brain that we use for planning and thinking about ourselves.

Impaired Awareness of Ilness: Approximately 50 percent of individuals with schizophrenia and manic-depressive disorder, including those who have never been treated, have impaired awareness of their own illness. This has been shown in at least 50 different studies. Such individuals do not realize that they are sick, and they will, therefore, usually not accept treatment voluntarily. Studies suggest that this impaired awareness is probably related to the decreased function of the prefrontal area of the brain.

These individuals are thus similar to some patients who have had a stroke and, because of brain damage, are unaware of their disability and deny it. The lack of awareness of illness in individuals with schizophrenia and manic-depressive disorder is the most common reason that they do not take their medication. [as can be seen in the research below, the part of the brain that is resonsible for self-analysis seems to be one of the areas most damaged by schizophrenia; the brain that is damaged, cannot frequently recognize that it is damaged]. This is a problem is because increasingly schizophrenia research is suggesting that the sooner a person with this brain disease is treated, the better the outcome for the person. Delays for treatment result in much worse outcome (see recent research below).

A Sample of Recent Relevant Research:

Additional Information on the Disease Process of Schizophrenia:

 


 

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