Can We Determine High Risk Groups in Schizophrenia? A Hypothesis

Yıl 2012, Cilt: 4 Sayı: 3, 371 - 380, 01.09.2012

Bülent Demirbek Osman Özdemir

https://doi.org/10.5455/cap.20120422

Öz

Neurodevelopmental hypothesis suggested that schizophrenia is a disorder of early brain development, in which the brain structural abnormalities are present. The causes of the abnormal processes remains unclear however, Genetics vulnerability, obstetric complications and viral infections have been shown to play a role in this disorder. Several studies have shown a greater incidence of winter or spring births in patients. Prenatal and perinatal infections, especially in the second trimester of pregnancy, have been considered a plausible risk factor for schizophrenia. Maternal exposure to influenza, herpes viruses, varicella zoster virus, Epstein-Barr virus, cytomegalovirus and rarely rubella virus infections confers an increased risk of schizophrenia to the developing offspring. As clinicians, we observed that our patients with psychotic disorder were not exposed to the viral infections even during epidemic. We hypothesized that perinatal viral infections have been associated with lifelong immunity to this infectious diseases which on the other hand cause an increased risk of developing schizophrenia. If we could determine antibodies against these viruses among patients with schizophrenia, perhaps we will be able to identify accurate markers heralding psychotic illness as well as can use these markers in a large population-based sample.

Anahtar Kelimeler

Schizophrenia, viral infections, biological marker

Şizofrenide Yüksek Risk Gruplarını Belirleyebilir miyiz? Bir Hipotez

Öz

Nörogelişimsel varsayım şizofreninin beynin gelişimi sırasında oluşmaya başlayan bir bozukluk olduğunu ileri sürer. Şizofreniye neden olan hatalı gelişime ilişkin etiyolojik faktörler tam olarak bilinmemekle beraber kanıtlar genetik yatkınlık, viral enfeksiyonlar, gebelik ve doğum komplikasyonlarının önemli bir rol oynadığını göstermektedir. Bazı çalışmalarda geç kış ya da bahar aylarında doğanlarda daha fazla şizofreni hastalığı olduğu bildirilmiştir. Merkezi sinir sistemine etkisi olan virüslerin özellikle ikinci trimesterde geçirildiklerinde şizofreni etiyolojisinde rol oynadıkları düşünülmektedir. Klinisyenler olarak biz psikotik hastalarımızda epidemi zamanlarında bile viral kökenli enfeksiyon hastalıklarına yakalanmadıklarını gözlemledik. Perinatal dönemde geçirilen bu viral enfeksiyonların bir yandan kişiyi bağışık hale getirirken diğer yadan da şizofreniye yatkın hale getirdiği hipotezini savunmaktayız. Eğer genel olarak viral patojenlere karşı gelişen antikorları şizofreni hastalarında ele alıp değerlendirebilirsek, belki de hastalığın habercisi olan bir biyolojik belirteç bulabilir ve bunu geniş örneklem gruplarında kullanabiliriz.

Anahtar Kelimeler

Şizofreni, viral enfeksiyonlar, biyolojik belirteç

Kaynakça

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• İpekyolu Develt Hastanesi, Van