Global versus local perspectives on schizophrenia.

摘要

Recent neurobiologi-cal studies indicate that schizophrenia may be a neurodevelopmental and progressive disorder with multiple biochemical abnormalities involving dopamine, serotonin, glutamate, and gamma-aminobu-tyric acid secretion. In postmortem tissue studies, structural abnormalities and alterations in synaptic connectivity have been observed in the intracortical circuitry of the pre-frontal dorsal cortex of schizophrenia patients. These morphological changes could be the sequelae of earlier environmental insults and genetic processes. There are probably multiple susceptibility genes, each of small effect, which act in conjunction with environmental factors as obstetric abnormalities, intrauterine infection, and abnormal nutrition. Candidate identified genes could influence neurodevel-opment, synaptic plasticity, and neurotransmission. The recent findings are consistent with notions that epigenetic factors play a major role in the disease process and epigenetic factors may continue to influence the expression of the affected genes in adulthood.