These Are the Potential Causes of Schizophrenia

hi my name is kyle kittleson with med circle and today i'm joined by double board certified psychiatrist dr dominic sportelli here to tell us some of the causes of schizophrenia dr don thanks for being here oh thanks for having me kyle it's always a pleasure on our series on schizophrenia which is available at watch.medcircle.com you explained that there were multiple causes of this disorder i'd like to start with some of the more popular causes of schizophrenia that we're aware of you know i think i think schizophrenia is it's when we're talking about schizophrenia we have to understand that we're working with theories schizophrenia is this group of symptoms that fit the diagnosis of schizophrenia and we know that it's something that's that's it's it's not common it's only about one percent of the population but people do fall into this consistent grouping of symptoms that we call schizophrenia so so everything that we're going to talk about tonight although backed by science and a lot of epidemiologic data it's still very theoretical so when we're talking about schizophrenia the weight the best way that we can just right off the bat explain the cause is that there are multiple genetic meaning hereditary and environmental risk factors and when i say environmental i mean like experience in life right all the things that we do to our bodies and and that the world does to us these will dictate our risk factors right so we know that schizophrenia is what we call a neurodevelopmental disorder we certainly know that it's organic there's something going on with neurochemistry and brain function but this is where it gets complicated is there is no single cause and i know that's probably so frustrating for people to hear and it's it's frustrating for me to hear as a clinician as a physician but again it's a complex gene and environment interactional process that just all comes together where people present with symptoms of schizophrenia understood i think the most helpless feeling at least emails i get uh are from people whose loved one is struggling with schizophrenia uh and their first question is where did this come from and so many of them share with me that it runs in their family their father their grandfather or somebody they're closely related to also showed similar symptoms what role does genetics actually play in the cause of schizophrenia genetics play a huge huge deal in this and and that gives us insight as doctors and researchers because obviously if something is genetic that means that there is information transferred from one person to the other in the genome in the dna of our cells the dna of our cells are instructions on how to build proteins and how to work basically so if it is something that is carried over from one person to the other which it is we'll talk about stats then we know there is something organic here there's something physical that is going on right um and when we're talking about genetics there are twin studies and the twin studies show that if you have an identical twin the likelihood will say an identical twin with schizophrenia the likelihood that you're gonna have schizophrenia is 50 now general population one percent of the general population so when you look at these twin studies and you say oh my goodness there's a 50 percent likelihood that an identical twin will have schizophrenia if the other one has it that's huge right compared to the general population of one percent also if both of your parents have schizophrenia the odds are about 40 percent that you will likely manifest symptoms of schizophrenia if your siblings have it or one parent has it it's a ten percent increase that you'll have schizophrenia and again this is all going against that baseline of the general population is about one percent so you know when we're talking about genetics it's obviously very very important and obviously a very big point yes absolutely those are great numbers to be aware of but like you mentioned it's just part of what could potentially cause schizophrenia i remember in a live class you talked about the and i do want to talk more about the environmental impacts that um plays into this but i remember in class you told me or told the viewers that drug use can create an episode of psychosis which is not schizophrenia but they are i'm not a doctor so i'm gonna use the bad terms but like they're not uh but they are related in some way so could you talk about whether or not what i just said was true or not and if um and the role that drug use can play in developing or quote causing schizophrenia absolutely and you know over the many many many years that we've been studying schizophrenia we totally know at this point that there are certain substances that can induce psychosis now remember when we talked about psychosis psychosis is a symptom very much in the same way that fever is a symptom right but it's sort of a general thing now psychosis is this disorganized thought process it's it's hallucinations delusions perceptual disturbances but there are certain substances that if we ingest or take it can cause psychosis now the the issue is that some people that experience psychosis with a substance it's called a substance induced psychosis sometimes it's not transient sometimes that psychosis will last even though the the drug wears off and that's where things get really complex and scary and then we say to ourselves as researchers and doctors like you know did the drug cause it or was this an effect of an underlying psycho like an underlying problem like schizophrenia where the drug or the substance sort of brought it to the surface right um so the question remains right is it was it the cause or sort of the effect but with regard to substances kyle we know for certain that there's this kind of hierarchy of substances that we know can induce psychosis and subsequently a schizophrenic type presentation and that hierarchy is cannabis right and we've studied cannabis for a really long time it's getting really popular these days so we know a lot more about it and we know a lot more about the cannabinoid system and we know that the cannabinoid system does play with dopamine in the brain which which is one of our theories of what's going on with schizophrenia so people that use cannabis especially people that use cannabis at a young age like in their adolescence before their brains are fully developed most of the literature supports about a four to six fold increase in potential for developing something like schizophrenia down the line right um the other matter the other i was going to call the medicines but the other substances are hallucinogens and hallucinogens are that category of substances that when you take you lose touch with reality for a little while and some examples of this are lysergic acid or lsd magic mushrooms or psilocybin um mdma can be considered a or ecstasy you know can be considered a hallucinogen us um peyote there's there's a lot of the mescaline a lot of these sort of hallucinogenic or in theogens there's a lot of names for them but can induce a psychotic state that just doesn't go away in potentially a sensitive individual and somebody that that might be predisposed to you know manifesting something like schizophrenia and the the next drug in the class would be amphetamines amphetamines believe it or not stimulants central nervous system stimulants at high doses for long periods of time can cause a schizophrenia type presentation that sometimes does not go away so cannabis hallucinogens and stimulants just a couple of other thoughts are you know just about any substance can induce a psychosis if you take too much right and we do know you know that people that are diagnosed with psychosis schizophrenia do tend to drink more alcohol um they tend to smoke more cigarettes you know they use other things as well but you know cannabis hallucinogens and amphetamines are the ones that we see are they sort of have that we call it the two hit hypothesis right and the two hit hypothesis as we talked about in some of our series is that someone is genetically predisposed to this or has a severe environmental load that we'll talk about like maybe like trauma or something like that and then they take something like a stimulant or lots of stimulants hallucinogens or lots of cannabis and it sort of kind of manifests as schizophrenia it's really incredible the power of what you just said because i think when people think of substance abuse or drug use they think of well i don't want the person i love to overdose and i don't want the person i love to become addicted and there is this other uh you know option here of heightening or releasing an otherwise asymptomatic uh mental health condition going on i remember when i was a really young i don't know maybe 10 or 11 or something my dad told me a story about somebody he knew who uh was picked up on the side of the road barking like a dog uh thinking believing that he was actually a dog and it was a i'm assuming i don't know but some psychosis or something going on from from drug use but he never got out of that and years later i actually met that guy where he was being cared for in a home and there was absolutely no attachment to reality there was constant statements that i'm the president of the united states or that you know he killed somebody the day before and all of these grandiose statements and at a young age i realized okay so drugs aren't just oh you might you know have fun on friday or you might risk becoming addicted there are long-term impacts that you may not be able to reverse and i share that story for people watching and listening not to scare people but really for those parents and caregivers if there is a familial history from what dr dom just shared with us of schizophrenia or psychosis then your child who may experiment with pot may have a heightened risk for having other types of negative consequences so there's there's a lot of power here with learning this education because that type of information allows parents to make informed decisions based on what's happening with their family and not what they just hear on tv or you know here on the news and then think it applies to them this is very specific and unique for each individual so this is great thank you for sharing that yeah really good point and you know what kyle don't forget i work in the emergency department in the psych emergency department and i see very very often too often you know more often than i want to see i see adolescents and young adults and adults for that matter who who are indulging in substance use and whether it's stimulants or you know anything really and you know it can trigger all types of you know psychiatric sequelae whether it's mania severe depression delusion paranoia i mean even alcohol withdrawal will make you paranoid and delusional you know so you know there are a lot of substances that will will cause some psychiatric issues that i think a lot of people don't really pay attention to um you know closely and you know that gentleman that you sort of talked about this you know this guy that was barking like a dog and and you know was was using a lot of substances the question remains right like was this someone that you know had an underlying psychotic issue and you know these drugs brought it out was this someone that was suffering from you know um a psychiatric issue that abused substances to self-medicate was this someone that had no symptoms prior to using these drugs and it sort of you know added fuel to the fire and made it happen it's hard to know but i could promise you one thing it certainly didn't help no let's talk about the environmental causes that you briefly mentioned at the top of this interview of schizophrenia how does that work yeah some really really interesting data with regard to environment and again when we talk about an environment it's it's the life you're living it's it's the life you're living and actually the substances that we just talked about fall into environment because if you're using these substances you're putting yourself more at risk but you know some of the other things with regard to environment are something called adverse childhood experiences and we call them aces aces you know when children experience severe trauma or childhood abuse or neglect it raises that risk of future potential for psychosis and schizophrenia so you know we we absolutely know that you know a child that goes through some really really difficult and challenging you know early developmental problems has a potential for something like psychosis but you know there's some really interesting data out there like do you know that there's something called the seasonal affect where when we do data and we look at epidemiological data people that are born in winter or spring tend to have a higher potential likelihood for something like schizophrenia and you know we don't really know why we have some theories as to this and one is a viral theory uh being that you know those times of year could potentially make the either the mother so you know carrying the fetus or a newborn child exposed to more viruses so there's a thought of potential a viral sort of insult that happens at a very young developmental age there's also low birth weight or prenatal complications you know all of these things put you in a higher risk stratification when it comes to schizophrenia malnutrition so there was there are times in history um where there were famines and uh when you look back at that data the individuals that were born during those famines had a much higher likelihood of developing schizophrenia which leads us to think that you know maybe malnutrition had a part of this as well so you know develop the development developing brain um is very sort of sensitive i mean it's a sensitive thing so malnutrition um any sort of prenatal compromise even things like hypoxia which means that you know you lose oxygen to the brain for a certain amount of time these are all things that have been implicated into a higher potential likelihood for schizophrenia in the future but remember all of these things it's this multiple sort of and again i'll use that term the perfect storm it's this it's this perfect storm of things that all sort of come together to raise your risk of schizophrenia and eventually potentially manifesting with symptoms consistent with schizophrenia this has been incredibly informative and i know there are viewers and watchers of this right now saying okay that was good information but now i have more questions and i find that happens a lot when you start to get educated about these complicated topics dr dominic sportelli has a few great series on schizophrenia and psychosis those are available at watch.medcircle.com and use the links below i'm also going to provide an inside look to one of those series at the end of this video dr dom i'm excited to see you tonight for our live panel i'm excited for people to get the chance to really ask you questions and get those clarifying answers again this is not treatment or therapy this is mental health education dr dom final words on uh schizophrenia and the causes well listen it's a scary thing right because you know schizophrenia is sort of like that when people think of the word insanity you know schizophrenia is kind of what comes to mind and it's very very frightening and i want people to remember that it's it's one percent of the population despite what we talked about with some things that will raise your risk but i also want people to know that people with schizophrenia can live a very normal life it is a spectrum just like anything else so you know and there's there's some really really amazing treatments out there nowadays so you know i always want people to remain hopeful if you have family friends loved ones that may have been diagnosed with something like schizophrenia there's certainly hope and some really really cutting-edge treatments out there now wonderful well we'll see you tonight i'm kyle kiddleson remember whatever you're going through you got this and here is an inside look into dr don series if i was walking down the street and a woman came up to me and she said i am so depressed i'm on my i think i'm going to kill myself can you help me i would say yes i'd get out my phone i call 9-1-1 i'd wait with her she'd go to the emergency room and hopefully she got help if a woman came up to me and said uh are you the king of england and you know was exhibiting symptoms of schizophrenia i would move around that person and continue on with my day now both people gave clear clear signs of a mental health disorder that can be treated and one i would help and one i would ignore such a profound insight kyle and i think that's the stigma is we're afraid of it we see it crazy yeah they're just crazy or on a drug trip or whatever and maybe they are on a drug trip or whatever hopeless yep not gonna help this person anyway not worth it right which is so sad because it's treatable yes it's treatable

Channel: MedCircle

Views: 298,768

Keywords: schizophrenia, causes of schizophrenia, causes, living with schizophrenia, living well with schizophrenia, what is schizophrenia, schizophrenia symptoms, mental health, schizophrenia treatment, mental illness, schizoaffective disorder, schizoaffective, psychiatry, paranoid schizophrenia, psychosis, treatment for schizophrenia, hallucinations, delusions, schizophrenia episode, psychology, paranoia, psychotic, depression, schizophrenic, mental health awareness, health, symptoms, medcircle, video

Id: kkiNjc2prVg

Length: 17min 52sec (1072 seconds)

Published: Thu Mar 11 2021