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NS 41 - Schizophrenia (iii) (Aetiology (risk factors (obstetric…
NS 41 - Schizophrenia (iii)
Aetiology
unknown, but not 1 exact single causal pathway
prevailing theory = neurodevelopmental hypothesis
faults in brain development
risk factors
urban birth
dose-response (more urban area -> increased risk)
migrant status
low social class (social class gradient)
born in winter/ 1st 3 months of year
maternal immune response to infection during pregnancy
'season of birth effect'
obstetric complications
maternal malnutrition
rhesus incompatibility
20% of patients had a birth complication
maternal influenza
maternal anaemia
preeclampsia
asphyxia
foetal distress
early childhood CNS infection
learning disability
slight delay in reaching developmental milestones
poor childhood friendships
early cannabis use (causative)
stressful life events (can precipitate onset)
area with different ethnic backgrounds (less protective)
less good at art, sport
genetic component
1 parent with it, 10% risk
non-mendelian
64% heritability
spectrum of contributing risk alleles
abnormalities on chromos 5,8,11,13,22
inconclusive
linked to other mental disorders: BPD, MDD, ASD
most cases have no family history
increased concordance in identical twins + children with 2 suffering parents
evidence for neurodevelopmental hypothesis
postmortems find maldeveloped cells + brain structures
brain imaging
gene abnormalities in gene that code for brain development
retrospective studies: decreased motor + language skills, cognition, social performance in childhood