Structural abnormalities in people with schizophrenia
Scenario:
A 22-year-old female student was brought to her college student health department by her boyfriend. He was concerned about the changes in her behavior. The boyfriend noted that she has been hearing voices, and seeing things that are not there. She also thinks that there are people that want to harm her. She told her family that she cannot finish college as the voices told her to quit because she is “dumb”. The boyfriend relates episodes of unexpected rage and crying.
PMH: noncontributory
FH: positive for a first cousin who “had mental problems”.
SH: Denies current drug abuse but states he smoked marijuana every day during junior and senior years of high school. Admits to drinking heavily on weekends at various fraternity houses.
PE: thin, anxious disheveled female who, during conversations, stops talking, tilts her head and appears to be listening to something. There is poor eye contact and conversation is disjointed.
DIAGOSIS: schizophrenia.
Questions:
Explain what structural abnormalities are seen in people with schizophrenia.
Brain abnormalities play an important role in the pathology of schizophrenia. The most consistent morphological findings are lateral ventricle enlargement, which is indicative of reduced brain volume, and third ventricular enlargement. Other results suggest volume reductions in cortical gray and white matter (Cannon et al 1998) and in specific brain regions such as the frontal lobes (Zipursky et al., 1992), the thalamus, and limbic structures, including the amygdala and hippocampus. It is now generally accepted that schizophrenia is associated with structural brain abnormalities, while the most consistent findings being enlarged lateral ventricles and reduced medial temporal and prefrontal lobe volumes (Shenton et al., 2001; Liddle and Pantelis 2003 pp. 403-417).