PATHOPHYSIOLOGY AND THERAPEUTIC APPROACHES TO SCHIZOPHRENIA: A LITERATURE REVIEW
DOI:
https://doi.org/10.47820/recima21.v5i6.5312Keywords:
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.
Downloads
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.
Downloads
Published
License
Copyright (c) 2024 RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218
This work is licensed under a Creative Commons Attribution 4.0 International License.
Os direitos autorais dos artigos/resenhas/TCCs publicados pertecem à revista RECIMA21, e seguem o padrão Creative Commons (CC BY 4.0), permitindo a cópia ou reprodução, desde que cite a fonte e respeite os direitos dos autores e contenham menção aos mesmos nos créditos. Toda e qualquer obra publicada na revista, seu conteúdo é de responsabilidade dos autores, cabendo a RECIMA21 apenas ser o veículo de divulgação, seguindo os padrões nacionais e internacionais de publicação.