PATHOPHYSIOLOGY AND THERAPEUTIC APPROACHES TO SCHIZOPHRENIA: A LITERATURE REVIEW

Authors

DOI:

https://doi.org/10.47820/recima21.v5i6.5312

Keywords:

Schizophrenia. Pathophysiology. Therapeutic approaches. Treatment and neurobiology.

Abstract

Schizophrenia is a chronic mental disorder that affects approximately 1% of the world's population, characterized by disturbances in thought, perception and behavior. This study aims to explore the pathophysiology and therapeutic approaches to schizophrenia, based on recent scientific literature. Objective: This literature review aims to synthesize the current evidence on the pathophysiology and therapeutic strategies of schizophrenia. Methods: A systematic search of scientific literature published between 2004 and 2024 was carried out using the PubMed, Web of Science, Scopus and Google Scholar databases. Original studies and reviews in English, Portuguese and Spanish were included. The initial screening identified 770 studies, of which 28 were analyzed in detail. Results and Discussion: The review highlighted structural and functional abnormalities in the brains of patients with schizophrenia, including reduced hippocampus volume and dopaminergic dysfunction. Genetic and epigenetic studies suggest a complex interaction between genetic and environmental factors. Early interventions, especially during the first psychotic episode, have been shown to significantly improve long-term outcomes. Antipsychotics remain the mainstay of treatment, although psychosocial therapies and neuromodulation techniques such as rTMS and tDCS are emerging as promising adjuncts. Conclusion: Schizophrenia requires a multifaceted and integrated approach for its effective management. Advances in neuroimaging, genetics and emerging therapies offer new hope for more effective treatments. Continued research and innovation are essential to address the challenges of this complex disease and improve outcomes for patients.

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Author Biographies

  • Luiz Fernando Araújo Guimarães Fernandes

    Acadêmico de Medicina. Instituto de Educação Superior do Vale do Parnaíba-IESVAP.

  • Daniel Oliveira Mendes Ferraz

    Acadêmico de medicina.

  • Júlia Mourão Quaresma

    Acadêmica de medicina.

  • Miguel Victor Monteiro Rodrigues

    Acadêmico de medicina.

  • Hailla Cristina Pereira Santos

    Acadêmica de medicina.

References

AL-GHESHIYAN, Nada A. Forced eruption: restoring nonrestorable teeth and preventing extraction site defects. General Dentistry, v. 52, n. 4, p. 327-333, 2004.

ALTAMURA, C. et al. Schizophrenia today: epidemiology, diagnosis, course and models of care. Journal of Psychopathology, v. 20, p. 223-243, 2014.

BARR, Mera S. et al. The effect of repetitive transcranial magnetic stimulation on gamma oscillatory activity in schizophrenia. PloS one, v. 6, n. 7, p. e22627, 2011. DOI: https://doi.org/10.1371/journal.pone.0022627

BUZINA, Nadica; PERIŠA, Ante; ARBANAS, Goran. The assessment of psychopathic traits in perpertrators with schizophrenia and psychopathy as comorbidity. Psychiatria Danubina, v. 33, n. suppl 4, p. 535-540, 2021.

COYLE, Joseph T. NMDA receptor and schizophrenia: a brief history. Schizophrenia bulletin, v. 38, n. 5, p. 920-926, 2012. DOI: https://doi.org/10.1093/schbul/sbs076

DE MACEDO RODRIGUES, Laíse Sofia. Perfil e custos de hospitalização de pacientes com esquizofrenia no Sistema Único de Saúde de Minas Gerais. [S. l. s. n.], 2015.

DEEPAK, D. K. Effect of adjunctive transcranial direct current stimulation to supplementary motor area and dorsolateral prefrontal cortex in obsessive compulsive disorder: A Randomized Double Blind Sham-controlled Study. 2017. Tese (Doutorado) - Central Institute of Psychiatry (India), 2017.

FABI, E. et al. Genetics and epigenetics of schizophrenia. La Clinica Terapeutica, v. 164, n. 4, p. e319-24, 2013.

FORNITO, Alex; ZALESKY, Andrew; BREAKSPEAR, Michael. The connectomics of brain disorders. Nature Reviews Neuroscience, v. 16, n. 3, p. 159-172, 2015. DOI: https://doi.org/10.1038/nrn3901

HANSON, Daniel R.; GOTTESMAN, Irving I. Theories of schizophrenia: a genetic-inflammatory-vascular synthesis. BMC medical genetics, v. 6, p. 1-17, 2005. DOI: https://doi.org/10.1186/1471-2350-6-7

HOWES, Oliver D.; MURRAY, Robin M. Schizophrenia: an integrated sociodevelopmental-cognitive model. The Lancet, v. 383, n. 9929, p. 1677-1687, 2014. DOI: https://doi.org/10.1016/S0140-6736(13)62036-X

INSEL, Thomas R. Rethinking schizophrenia. Nature, v. 468, n. 7321, p. 187-193, 2010. DOI: https://doi.org/10.1038/nature09552

KANAI, Ryota; REES, Geraint. The structural basis of inter-individual differences in human behaviour and cognition. Nature Reviews Neuroscience, v. 12, n. 4, p. 231-242, 2011. DOI: https://doi.org/10.1038/nrn3000

KANE, John M. et al. Comprehensive versus usual community care for first-episode psychosis: 2-year outcomes from the NIMH RAISE early treatment program. American Journal of Psychiatry, v. 173, n. 4, p. 362-372, 2016. DOI: https://doi.org/10.1176/appi.ajp.2015.15050632

KEGELES, Lawrence S. et al. Elevated prefrontal cortex γ-aminobutyric acid and glutamate-glutamine levels in schizophrenia measured in vivo with proton magnetic resonance spectroscopy. Archives of general psychiatry, v. 69, n. 5, p. 449-459, 2012. DOI: https://doi.org/10.1001/archgenpsychiatry.2011.1519

KOUIDRAT, Youssef et al. Eating disorders in schizophrenia: implications for research and management. Schizophrenia research and treatment, v. 2014, 2014. DOI: https://doi.org/10.1155/2014/791573

LEUCHT, Stefan et al. Antipsychotic drugs versus placebo for relapse prevention in schizophrenia: a systematic review and meta-analysis. The Lancet, v. 379, n. 9831, p. 2063-2071, 2012. DOI: https://doi.org/10.1016/S0140-6736(12)60239-6

MARZOUK, Taylor et al. Transcranial magnetic stimulation for positive symptoms in schizophrenia: a systematic review. Neuropsychobiology, v. 79, n. 6, p. 384-396, 2020. DOI: https://doi.org/10.1159/000502148

MCGOWAN, Patrick O. et al. Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse. Nature neuroscience, v. 12, n. 3, p. 342-348, 2009. DOI: https://doi.org/10.1038/nn.2270

MCGRATH, John J.; SUSSER, Ezra S. New directions in the epidemiology of schizophrenia. Medical Journal of Australia, v. 190, n. S4, p. S7-S9, 2009. DOI: https://doi.org/10.5694/j.1326-5377.2009.tb02366.x

MONDINO, Marine; SAUVANAUD, Florence; BRUNELIN, Jérôme. A review of the effects of transcranial direct current stimulation for the treatment of hallucinations in patients with schizophrenia. The journal of ECT, v. 34, n. 3, p. 164-171, 2018. DOI: https://doi.org/10.1097/YCT.0000000000000525

NESTLER, Eric J. Epigenetic mechanisms of depression. JAMA psychiatry, v. 71, n. 4, p. 454-456, 2014. DOI: https://doi.org/10.1001/jamapsychiatry.2013.4291

PANTELIS, Christos et al. Biological insights from 108 schizophrenia-associated genetic loci. Nature, v. 511, n. 7510, p. 421-427, 2014. DOI: https://doi.org/10.1038/nature13595

PAPAKOSTAS, George I.; LARSEN, Klaus. Testing anxious depression as a predictor and moderator of symptom improvement in major depressive disorder during treatment with escitalopram. European archives of psychiatry and clinical neuroscience, v. 261, p. 147-156, 2011. DOI: https://doi.org/10.1007/s00406-010-0149-3

RESER, Maree P.; SLIKBOER, Reneta; ROSSELL, Susan L. A systematic review of factors that influence the efficacy of cognitive remediation therapy in schizophrenia. Australian & New Zealand Journal of Psychiatry, v. 53, n. 7, p. 624-641, 2019. DOI: https://doi.org/10.1177/0004867419853348

SMITH, Matthew J.; CSERNANSKY, John G. Clinical implications of alcohol-use disorders in schizophrenia. Neuropsychiatry, v. 2, n. 3, p. 1-14, 2012. DOI: https://doi.org/10.2217/npy.12.21

WORLD HEALTH ORGANIZATION. Schizophrenia. [S. l.]: World Health Organization, 2022.

Published

05/06/2024

How to Cite

PATHOPHYSIOLOGY AND THERAPEUTIC APPROACHES TO SCHIZOPHRENIA: A LITERATURE REVIEW. (2024). RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218, 5(6), e565312. https://doi.org/10.47820/recima21.v5i6.5312